Healthcare Payment Specialists Jobs in Charleston

Description The Senior Vendor Management Professional with Humana manages a diverse scope of complex vendor projects in collaboration with all areas of Claims Cost Mgt (CCM) in an effort to reduce ..

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 ..

Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Charleston West Virginia Description The Fraud and Waste Professional 2 conducts investigations of allegations ..

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 ..

Job Information Humana FP&A Lead in Charleston West Virginia Description The Financial Planning & Analysis Lead analyzes and forecasts financial, economic, and other data to provide accurate and timely information for ..

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 ..

Job Information Humana Lead Lean Portfolio Management in Charleston West Virginia Description Responsibilities The Lead, Lean Portfolio Management works closely with Product Management, Architecture and Finance to understand the portfolio of ..

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 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 Information Humana Lead Cloud Advocate in Charleston West Virginia Description Humana Cloud Adoption Services team is looking for a Lead Technology Leadership Professional responsible to deliver new technological solutions coordinating ..

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 As the Associate Director, Customer Success for Humana Pharmacy Solutions, you are accountable to provide strategic direction and leadership to maximize the utilization of pharmacy products and services while building ..

... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..

... Qualifications Minimum 5 years of healthcare fraud investigations and/or auditing experience ... of Florida and Wisconsin Medicaid healthcare payment methodologies Strong organizational, interpersonal, and ... the required qualifications. Understanding..

... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..

Job Information Humana Lead Technology Leadership Professional in Charleston West Virginia Description The Lead Technology Leadership Professional is responsible for all aspects of software or hardware product delivery and performance. The ..

Description The UM Administration Coordinator 2 contributes to administration of utilization management. Responsibilities The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate ..

Job Information Humana Lead, Portfolio Management in Charleston West Virginia Description Responsibilities Job Description The Lead, Portfolio Management role collaborates with Customer Experience Center Platform (CECP) leadership and external teams to ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Charleston West Virginia Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..

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 ..