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Job Information Humana Actuary, Risk and Compliance in Montpelier Vermont Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..
... 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..
Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..
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 ..
... in Montpelier Vermont Description Responsibilities Healthcare isn't just about health anymore. ... of our members, and the healthcare industry as a whole. Assignment ... enhance data analytics and operational..
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, ..
Job Information Humana FP&A Lead, Medicaid Market in Montpelier Vermont Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description The Lead Technology Leadership Professional is responsible for all aspects of software or hardware product delivery and performance. The Lead Technology Leadership Professional works on problems of diverse scope and ..
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 ..
... internal stakeholders in support of Healthcare Interoperability and compliance to CMS ... criteria for the measurement of Healthcare Interoperability and compliance to CMS ... areas with issue resolution and..
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 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 Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Montpelier Vermont Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
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 ..
Description Healthcare isn't just about health anymore. ... of our members, and the healthcare industry as a whole. Responsibilities ... excellence, consistent process monitoring and improvement. Effectively influence the multiple..
Description The Site Reliability Engineering (SRE) Lead Technology Leadership Professional - Pharmacy Dispensing Solutions is responsible for all aspects of the production environment support strategy, Operational Excellence strategy and execution, and ..
Job Information Humana Vendor Management Specialist 3 in Montpelier Vermont Description ... Vermont Description The Vendor Management Specialist 3 works as liaison between ... and organization. The Vendor Management Specialist..
