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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 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 Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
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 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 ..
... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural Healthcare Distinction, and/or LTSS Distinction Auditing ... job as we are a..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
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 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 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 ..
Job Information Humana Medicare Risk Adjustment Representative 3 (Scheduler) in Albany New York Description The Risk Adjustment Representative 3 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that ..
Description SeniorBridge/Humana is seeking a Care Management Support Assistant. This professional contributes to the successful administration of home care by providing administrative support in new and existing Home Care markets. This ..
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 The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates new product ideas, enhance existing products or strategic product extensions, and translates research discoveries into marketable products. This ..
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 ..
Job Information Humana Actuary, Risk and Compliance in Albany New York Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare ..
... On-Call hours as-needed. The On-Call Scheduling Specialist performs varied activities and ... administrative/operational/customer support assignments, including paraprofessional scheduling and general office functions of ... size of the branch, the..
Description Humana's Claims Cost Management (CCM) organization is seeking a Manager, Fraud & Waste to join the Provider Payment Integrity-Clinical Audit team working remote anywhere in the US. As the Fraud ..
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 ..
