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Description The Senior Business Intelligence Engineer (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer ..
Description The Provider Insights & Claims Analytics (PICA) team is a blend of technology, data, and consulting professionals leveraging the latest tools and methods to solve complex business problems. In this ..
Description The Business Intelligence 2 - Provider Intelligence and Claims Analytics (PICA) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The ..
Description The Senior Business Intelligence Analyst (Claims Strategy) solves complex business ... decision-makers. The Senior Business Intelligence Analyst work assignments involve moderately complex ... In The Senior Business Intelligence Analyst..
... this role the Business Intelligence Analyst solves complex business problems and ... to decision-makers. The Business Intelligence Analyst work assignments are varied and ... well-being Responsibilities The Business Intelligence..
Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..
Job Information Humana Senior Financial Analyst - Remote in Montpelier Vermont ... vision is to improve member healthcare through innovative analytics and actionable ... is seeking a Senior Financial Analyst..
Description The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of ..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Job Information Humana Senior Financial Analyst - Remote Nationwide in Montpelier ... Vermont Description The Senior Financial Analyst for Humana's Direct Contracting Entity, ... operational effectiveness. The Senior Financial Analyst..
Description The STARS Improvement Analyst develops, implements, and manages oversight ... and initiatives. The STARS Improvement Analyst work assignments are varied and ... well-being Responsibilities The STARS Improvement Analyst develops..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Montpelier Vermont Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business ..
Job Information Humana Senior Risk Management Professional - Pharmacy claims in Montpelier Vermont Description The Senior Risk Management Professional identifies and analyzes potential sources of loss to minimize risk. The Senior ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Montpelier Vermont Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
... aspects related to reviewing pharmacy claim submissions for accuracy and appropriateness. ... tone and standard for pharmacy claim review. The Pharmacy Claims Professional ... pharmacies, make determination of appropriate..
Job Information Humana Pharmacy Claims Specialist, Remote in Montpelier Vermont Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 performs ..
Job Information Humana Senior Process Improvement Professional/HGB (TRICARE Benefits, Claims processing exp.) Remote Nationwide in Montpelier Vermont Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business ..
Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
... Humana Lead Product Manager - Healthcare API in Montpelier Vermont Description ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
Description The Claims Review Representative 4 (formerly Team lead), Financial Recovery Overpayment Team makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. ..
