Healthcare Payment Specialists Jobs in South Dakota

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 Aberdeen South Dakota Description The Fraud and Waste Professional 2 conducts investigations of allegations ..

This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit ..

... 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 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 ..

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

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 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 ..

Job Information Humana Compliance Professional 2 - Medicaid in Aberdeen South Dakota Description Responsibilities Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. ..

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 Pharmacy Claims Specialist, Remote in Aberdeen South Dakota Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 ..

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 ..

... 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..

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 Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Aberdeen South Dakota Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..

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 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 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 ..

Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..

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 Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..

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