Healthcare Claim Project Manager Jobs in Middletown

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..

Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..

Job Information Humana Service Alignment Manager (SAM) - Remote, nationwide in ... Ohio Description The Service Alignment Manager (SAM) is an individual contributor ... Technology experience with PPS systems, project..

Job Information Humana Call Center Pharmacy Claims Technician, Remote in Cincinnati Ohio Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative ..

Job Information Humana Manager, Release Management, Remote in Cincinnati ... in Cincinnati Ohio Description The Manager, Release Management Engineering manages cross-organizational ... into the production environment. The Manager, Release Management..

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 Pharmacy Claims Specialist, Remote in Cincinnati Ohio Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 performs ..

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 ..

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. ..

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 ..

... 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 , Provider Engagement in Cincinnati ... in Cincinnati Ohio Description The Manager, Provider Engagement develops and grows ... relationships with physicians, providers and healthcare systems in..

Job Information Humana Manager, Pharmacy and Medical Trend in Cincinnati Ohio Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and medical, ..

Job Information Humana Manager, Operations, Release and Process in ... in Cincinnati Ohio Description The Manager, Release Management Engineering manages cross-organizational ... into the production environment. The Manager, Release Management..

Job Information Humana Manager, Fraud and Waste-Remote US in ... in Cincinnati Ohio Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..

... KEY ACCOUNTABILITIES Process Improvement and Project Management Contributes to the identification ... projects, key insights, and ensure project milestones and deliverables are implemented ... manner Develops and manages detailed..

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 ..

Job Information Humana Manager of Release Engineering, Remote in ... in Cincinnati Ohio Description The Manager, Release Management Engineering manages cross-organizational ... into the production environment. The Manager, Release Management..

Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Cincinnati Ohio Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible for the administration and monitoring of the Autism ..

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..

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 ..