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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 ..
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Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team working remote/from home anywhere in the U.S. Responsibilities As a Board Certified ..
Description Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional consults and collaborates with clinicians/nurses to ensure high accountability of compliance and quality and claims are being reviewed correctly. This position ..
Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review of ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
... day. The Patient Financial Access Specialist-ED is responsible for all functions ... patient safety. Understands the various insurance carriers by electronically verifying insurance eligibility and enters insurance accurately to..
Description The Risk Adjustment Representative 3 works with regional provider offices to ensure timely submission of requested medical records that are submitted to the Centers for Medicare and Medicaid Services (CMS) ..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
... day. The Patient Financial Access Specialist - OP is responsible for ... appointments and manages patient and insurance demographics to ensure appropriate reimbursement ... identified within the system. 2...
Description The Senior Clinical Pharmacy Advisor - Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high performing team that helps ..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Description SeniorBridge is hiring a Per Diem Scheduler to cover On-Call hours as-needed. The On-Call Scheduling Specialist performs varied activities and moderately complex administrative/operational/customer support assignments, including paraprofessional scheduling and general ..
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 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 The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high ..
Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, ..
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 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 The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Description SeniorBridge is hiring an experienced Home Health Scheduling Coordinator. This is a Work-At-Home position. The Scheduling Specialist is responsible for carrying out the day to day paraprofessional scheduling and general ..
