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Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
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Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Job Functions, Duties, Responsibilities and Position Qualifications: Quality is in our DNA -- is it in yours? You put the pro in medical laboratory professional. You've got problem-solving instincts, a passion ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Birmingham Alabama Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..
... We are the future of healthcare and our mission is to ... will help members through their healthcare journey, ensuring they get the ... are: Passionate about transforming our..
Admin / Clerical (197) Advanced Practice Registered Nurses / Physician Assistants (340) Allied Health (3222) Executive (80) Operations (255) Physicians/Surgeons (1359) Quality/Risk Management (18) Type Contract (1) Fellowship (0) Full Time ..
Description The Staff Clinical Pharmacist is an integral part of the Clinical Drug Policy Management team which ensures synchronization of formulary utilization management policies across multiple systems. Humana is seeking a ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Birmingham Alabama Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Job Information Humana FP&A Lead, Medicaid Market in Birmingham Alabama Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
... Certified Diabetes Care and Education Specialist-Remote-US in Birmingham Alabama Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
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 Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
