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Description The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..
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Description The Inbound Contacts Representative 4 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer ..
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 Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Description The Care Management Support Assistant 2 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 The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
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 Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
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 ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Riverton Wyoming Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for claims reserve valuation, financial forecasting, and strategic and operational decisions within ..
Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
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 ..
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 The Associate Actuary, SPA RX will be mainly responsible for supporting the pricing work related to our standalone Prescription Drug Plans (PDPs). This includes both bid development and reforecasts throughout ..
Job Information Humana Telephonic Care Coach- WAH Nationwide in Riverton Wyoming Description The Care Coach 1, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain ..
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 ..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
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 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 ..
