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Description The Senior Claims Process & Policy Professional processes new insurance policies, modifications to existing policies, and claims forms. The Senior Claims Process & Policy Professional work assignments involve moderately complex ..
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Description The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments ..
Description Market Development Advisor supports the Regional President, Humana Florida Medicaid, by leading strategic health plan initiatives in collaboration with senior health plan leaders and across the enterprise. This role partners ..
Description Responsibilities The ACD Referral Authorization Coordinator Lead role will assist the Supervisor in oversight & monitoring of processing and timeliness standards for referrals and authorizations under the Autism Care Demonstration ..
Job Information Humana Clinical Provider Quality Improvement Field RN - Orange, Osceola, Polk County, FL in Tampa Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and ..
Description The Senior EAP Onsite Counselor provides ongoing and crisis intervention focused on the emotional, social, vocational, educational, health-related, developmental, and organizational concerns that impact daily lives. The Senior Counselor work ..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Tampa Florida Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese and ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
Job Information Humana Clinical Provider Quality Improvement Field RN - Orange, Osceola, Polk County, FL in Kissimmee Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and ..
Job Information Humana Clinical Provider Quality Improvement Field RN - Orange, Osceola, Polk County, FL in Apopka Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and ..
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 ..
Job Information Humana Clinical Provider Quality Improvement Field RN - Orange, Osceola, Polk County, FL in Winter Park Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation ..
Description The Financial Reporting Lead prepares and distributes periodic financial statements for users other than those directly employed by the organization. The Financial Reporting Lead works on problems of diverse scope ..
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 ..
Job Information Humana Clinical Provider Quality Improvement Field RN - Orange, Osceola, Polk County, FL in Orlando Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and ..
Description This is a salaried exempt position with responsibility for utilization management oversight and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in the TRICARE Operations Manual Chapter ..
Job Information Humana Sr. STARS Improvement Registered Nurse, RN, Professional - Pensacola or Panama City, FL in Pensacola Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation ..
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 ..
Job Information Humana Provider Contracting Manager in Doral Florida Description The Provider Contracting Manager initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides ..
Description The Genetic Counselor 2 responsible for evaluating and understanding member's risk of inherited medical condition. The Genetic Counselor 2 work assignments are varied and frequently require interpretation and independent determination ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
