Healthcare Claim Project Manager Jobs in Woodridge

Claims Analyst (Legal Affairs) The candidate will be responsible for initiating and maintaining the litigation files. Will conduct discovery at the request of the in-house and assigned defense counsel. Will attend ..

Claims Analyst (Legal Affairs) Duties: Be responsible for initiating and maintaining the litigation files. Conduct discovery at the request of the in-house and assigned defense counsel. Attend and participate (including preparation ..

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..

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

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

Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..

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

PURPOSE AND SCOPE:Provides employee relations support, guidance and advice to field management and employees in assigned regions within a FMS Division. Ensures compliance with company policies and procedures, and local, state ..

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

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 Call Center Pharmacy Claims Technician, Remote in Chicago Illinois Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative ..

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 ..

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

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 ..

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 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 of Release Engineering, Remote in ... in Chicago Illinois Description The Manager, Release Management Engineering manages cross-organizational ... into the production environment. The Manager, Release Management..

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 The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..

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 ..

... 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..

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. ..