Healthcare Payment Specialists Jobs

Online Medical Research (German & English Fluent Required) Quick & Easy Description We need help finding doctors/medical specialists to treat a patient. The right applicant for this job will be a ..

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 Care Management Support Specialist in Honolulu Hawaii Description A day in the life of a CMSS would consist of being aligned to one of over 6 different tasks ..

Job Information Humana Lead Lean Portfolio Management in Honolulu Hawaii Description Responsibilities The Lead, Lean Portfolio Management works closely with Product Management, Architecture and Finance to understand the portfolio of current-year, ..

Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..

Description Humana drives innovation to create artificial intelligence, machine learning, and data-driven platforms, products, and services for the entire organization. The Artificial Intelligence Engineering team is a crucial part responsible for ..

Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of ..

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 FP&A Lead, Medicaid Market in Honolulu Hawaii Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..

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

Job Information Humana Lead Technology Leadership Professional ( Remote Opportunity) in Honolulu Hawaii Description The SRE Lead Technology Leader drives the SRE Technical operational excellence strategy and production support for applications ..

... 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..

Description The 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 works on ..

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 ..

... 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..

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

Job Information Humana Senior Integration Specialist - Cloud in Honolulu Hawaii Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating functional silos existing between development ..

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 ..

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

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 ..