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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Description The Senior Project Manager manages all aspects of a ... manages all aspects of a project, from start to finish, so ... and within budget. The Senior Project Manager..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Job Information Humana Manager, Operations, Release and Process in ... Fargo North Dakota Description The Manager, Release Management Engineering manages cross-organizational ... into the production environment. The Manager, Release Management..
... of services provided by other healthcare professionals in compliance with review ... issues regarding technical approach for project components, and work is performed ... whether services provided by other..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Manager, Release Management Engineering manages cross-organizational ... into the production environment. The Manager, Release Management Engineering works within ... schedules and goals. Responsibilities The Manager, Release Management Engineering..
Job Information Humana Medical Director of Trend Analytics in Fargo North Dakota Description Humana's ECM organization is seeking a Medical Director of Trend Analytics. As a clinical trend leader you will ..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Fargo North Dakota Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible for the administration and monitoring of the ..
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. ..
Job Information Humana UM Medical Director - Conviva in Fargo North Dakota Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Job Information Humana Medical Director - Texas in Fargo North Dakota Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Manager of Release Engineering, Remote in ... Fargo North Dakota Description The Manager, Release Management Engineering manages cross-organizational ... into the production environment. The Manager, Release Management..
Job Information Humana Manager, Release Management, Remote in Fargo ... Fargo North Dakota Description The Manager, Release Management Engineering manages cross-organizational ... into the production environment. The Manager, Release Management..
... of services provided by other healthcare professionals in compliance with review ... issues regarding technical approach for project components, and work is performed ... working with health insurance other..
Job Information Humana Pharmacy Claims Specialist, Remote in Fargo North Dakota Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 ..
Job Information Humana Call Center Pharmacy Claims Technician, Remote in Fargo North Dakota Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims ..
Description The Manager, Fraud and Waste, Genetic Counseling provides clinical support for investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works within specific guidelines ..
Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. Responsibilities There are 4 shifts available for this role. All ..
Job Information Humana Manager, Fraud and Waste-Remote US in ... Fargo North Dakota Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
... of 6 Product Owners and Project Managers Requirements gathering, project management oversight, user acceptance testing, ... and education. Create and present project status updates, financial impacts, etc. ... Qualifications..
Job Information Humana Manager, Pharmacy and Medical Trend in Fargo North Dakota Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and ..
