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Claim Manager Duties: Direct and monitor areas of casualty accountability within assigned authority to produce and ensure claim outcomes consistent with policy coverage, damages and the law. Provide input into the ..
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 ..
Description The Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
Description The Senior Vehicle Fleet Management Professional operates and maintains motor vehicles and equipment. Schedules and dispatches the organization's vehicles and drivers. The Senior Vehicle Fleet Management Professional work assignments involve ..
Description The Cyber Security Metrics Lead will drive the effort to build a comprehensive and sustainable cyber security metrics and reporting program based on a defined strategy. They will do this ..
Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Supervisor, Grievances & Appeals ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
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 ..
Job Information Humana Supervisor, Grievances & Appeals - Remote, ... in Montpelier Vermont Description The Supervisor, Grievances & Appeals manages client ... an appeal is warranted. The Supervisor, Grievances &..
Description The Supervisor, Grievances & Appeals manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if a grievance, appeal, or further request is warranted ..
Description The Lead Technology Support Specialist enables a reliable technology experience for Humana's senior leaders (C-suite, SVPs, etc.) and their staff members. The Lead Technology Support Specialist maintains, repairs, and troubleshoots ..
Description The Care Delivery Tele Sales Supervisor supports and develops a team of Care Delivery Tele Sales Agents. The Care Delivery Tele Sales Supervisor provides timely and effective support to assist ..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Montpelier Vermont Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Job Description An Operations Supervisor is a key leader supporting the CVS Store Management team in planning and driving store execution and performance while building consumer loyalty to CVS/pharmacy through a ..
Job Information Humana Supervisor, UM Administration-Remote in Montpelier Vermont Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; ..
Description The Supervisor, Provider Engagement develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working ..
Description The Supervisor, Quality Engineering carries out procedures to ensure that all information systems products and services meet organization standards and end-user requirements. The Supervisor, Quality Engineering works within thorough, prescribed ..
Description The Supervisor, Care Management Support 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 wellness ..
Description The Senior Software Engineer (Web, Mobile, iOS, Android) codes software applications based on business requirements. The Senior Software Engineer work assignments involve moderately complex to complex issues where the analysis ..
