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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 ..
Job Information Humana Call Center Pharmacy Claims Technician, Remote in Albuquerque New Mexico Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims ..
... 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..
Job Information Humana Senior Financial Analyst - Remote Nationwide in Albuquerque ... Mexico Description The Senior Financial Analyst for Humana's Direct Contracting Entity, ... operational effectiveness. The Senior Financial Analyst..
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 ..
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 ..
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 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 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..
Job Information Humana Senior Financial Analyst - Remote in Albuquerque New ... vision is to improve member healthcare through innovative analytics and actionable ... is seeking a Senior Financial Analyst..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Albuquerque New Mexico Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing ..
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 ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
... 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..
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 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 ..
POSITION SUMMARY: Coordinates the process for completion and transmission of the resident assessment instrument (RAI) inbyhe regulatory requirements, including assisting with the completion of the Minimum Data Set (MDS) and Care ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Albuquerque New Mexico Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be ..
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 ..
Job Information Humana Senior Process Improvement Professional/HGB (TRICARE Benefits, Claims processing exp.) Remote Nationwide in Albuquerque New Mexico Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing ..
... Humana Lead Product Manager - Healthcare API in Albuquerque New Mexico ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
