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Description The Senior Application Architect designs and develops IT applications architecture solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments involve ..
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... technological solutions to meet Medicaid business needs within a specified scope ... developing, guiding, and documenting clinical business system and functional processes, influences system design to optimize support and..
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 ..
... is look for a Senior Business Systems Analyst to join working remote anywhere ... in the US! The Senior Business Systems Analyst performs analysis of business, process and user..
... as a focus on collaborative business relationships, value based care, population ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
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 ..
... course of action. Humana Government Business government contract requires U.S. citizenship ... Qualifications 3 plus years of healthcare fraud investigation experience 2 plus ... knowledge and experience Experience in..
Description Healthcare is rapidly changing, and our ... able to work closely with business leaders in Care Management to ... outcome metrics aligned to driving business and strategic goals of..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
... and executing on Humana's consumer-focused business strategy demands constant negotiation with ... and documentation within a tracking system. May assist with identifying and ... to ensure effective and efficient..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
... criteria in the Formulary Enterprise System Evaluates new medications and accurately ... Collaborates with other pharmacists and healthcare professionals in a team environment ... Manages and communicates line of..
Description The Medical Coding Auditor Supervisor handles a combination of tasks, including extracting clinical information from a variety of medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, ..
Description The Senior User Interface Design Engineer is generally focused on the look, feel, operation, user experience and functionality of a commercial website. Creates internal/external company web pages including graphics, animation ..
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 Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
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 ..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
Description The Staff RX Clinical Programs Pharmacist integrates programs developed to improve overall health outcomes with a focus on prescription drugs. The Staff RX Clinical Programs Pharmacist work assignments involve moderately ..
Description The Senior HR Business Partner; Primary Care Organization leads ... people management agenda in a business unit/area, and acts as a ... of expertise. The Senior HR Business Partner..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... report information for end-users using system tools and database or data ... Medicaid Quality Data and Reporting..
