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Description The Senior Clinical Business Professional manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Senior Clinical Business Professional ..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Description The Care Management Support Assistant 3 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 ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
Description The Senior Market Finance Professional collects, analyzes and reports on various market data to connect financial outcomes with operational effectiveness. The Senior Market Finance Professional work assignments involve moderately complex ..
Job ID 21000FMNAvailable Openings 2 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Professional works on problems ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Charleston West Virginia Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Analyst works on problems ..
... or CAHPS) in a quality operations / quality management or office ... Qualifications Bachelor's degree in Business, Healthcare, or related field Certified Professional ... related field Certified Professional in..
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 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 Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
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 ..
