Healthcare Payment Specialists Jobs in San Juan

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 San Juan Puerto Rico Description The Fraud and Waste Professional 2 conducts investigations of ..

Job Information Humana FP&A Lead, Medicaid Market in San Juan Puerto Rico Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South ..

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 ..

Job Information Humana Senior Integration Specialist - Cloud in San Juan Puerto Rico Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating functional silos existing ..

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 Cloud Advocate in San Juan Puerto Rico Description Humana Cloud Adoption Services team is looking for a Lead Technology Leadership Professional responsible to deliver new technological solutions ..

Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Supervisor, Grievances & Appeals ..

Description The Sales Support Professional 1 provides timely and effective sales administrative support to assist with the acquisition or retention of customers. The Sales Support Professional 1 work assignments are often ..

... 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..

... 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..

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 ..

... 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 Pharmacy Claims Specialist, Remote in San Juan Puerto Rico Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative ..

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

Job Information Humana Lead Lean Portfolio Management in San Juan Puerto Rico Description Responsibilities The Lead, Lean Portfolio Management works closely with Product Management, Architecture and Finance to understand the portfolio ..

Job Information Humana Compliance Professional 2 - Medicaid in San Juan Puerto Rico Description Responsibilities Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life ..

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 ..

Description Humana's Corporate Marketing organization is seeking a seasoned communications expert to join our Internal Communications Team, supporting the transformation of Humana's core insurance technology systems and operating model - known ..

Job Information Humana Lead Technology Leadership Professional ( Remote Opportunity) in San Juan Puerto Rico Description The SRE Lead Technology Leader drives the SRE Technical operational excellence strategy and production support ..