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Description The Senior Risk Management Professional will be responsible for managing third party risk management (TPRM) work streams to support Humana's overall TPRM Program. Responsibilities include risk identification, data analysis, process ..
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Description The Director, Process Improvement analyzes, and measures the ... sustainable, repeatable and quantifiable business process improvements. The Director, Process Improvement requires an in-depth understanding ... or segment. Responsibilities The..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Albany New York Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Job Information Humana Healthcare Lead Product Manager: Hispanic Segment Medicare Advantage in Albany New York Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Hispanic MA customer ..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
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 ..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
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 Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
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 Actuary, Analytics/Forecasting will develop the financial forecast for the dental and vision benefits included within Humana's growing Medicare Advantage business, as well as pricing and oversight of other stand ..
Description The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and ..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships ... goals. The Senior Value-Based Programs Analyst works on problems of diverse ... Responsibilities The Senior Value-Based Programs Analyst..
Description The Senior Product Manager conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of ..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The Pharmacy ..
Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships ... Responsibilities The Senior Value-Based Financial Analyst advises executives to develop functional ... Qualifications Bachelor's degree in Business, Healthcare,..
... multiple priorities Commitment to continuous process improvement Exceptional verbal and written ... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..
... for a Senior Business Systems Analyst to join working remote anywhere ... US! The Senior Business Systems Analyst performs analysis of business, process and user needs, documentation of .....
Description The Clinical Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also pulls ..
