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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and ..
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, ..
Description The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Senior Fraud and Waste Professional work assignments involve moderately complex to complex issues where ..
Job Information Humana Specialty Drug Site of Care Specialist in Aberdeen South Dakota Description The Specialty Pharmacy Programs Clerk 2 supports clinical programs and comprehensive insights directly related to Specialty Pharmacy ..
Job Information Humana Vulnerability Remediation Specialist (Remote) in Aberdeen South Dakota Description The Systems Engineer 2 is responsible for design, analysis, configuration and maintenance of complex systems software solutions, based on ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Aberdeen South Dakota Description The Fraud and Waste Professional 2 conducts investigations of allegations ..
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 The UM Specialist /UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Job Information Humana Vendor Management Specialist 3 in Aberdeen South Dakota ... Dakota Description The Vendor Management Specialist 3 works as liaison between ... and organization. The Vendor Management Specialist..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Job Information Humana Pharmacy Special Investigations Professional (Fraud, Waste & Abuse) Remote in US in Aberdeen South Dakota Description The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent ..
Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..
Job Information Humana Pharmacy Claims Specialist, Remote in Aberdeen South Dakota Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 ..
Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
Description The Pharmacy Development Specialist will be responsible for qualifying and managing new business leads and cultivating prospects and sales. Responsibilities Summary The Business Development Specialist will be responsible for managing ..
Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
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 ..
Job Information Humana Senior Integration Specialist - Cloud in Aberdeen South Dakota Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating functional silos existing between ..
