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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 ..
Description The MarketPoint Sales Representative - PR sells individual health plan products and services in a field setting. The MarketPoint Sales Representative - PR work assignments involve moderately complex to complex ..
Description The Care Management Support Assistant 3 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 Claims Research & Resolution Representative 2 (Bilingual - English/Spanish) (Remote) in San Juan Puerto Rico Description The Bilingual Claims Research and Resolution Representative 2 address customer needs which ..
Job Information Humana Business Systems Analyst Professional 2/TPA (Renewable Contract position with Full Benefits) Work at Home Puerto Rico in San Juan Puerto Rico Description The Business Systems Analysis Professional 2 ..
Description The Product Manager 2 Conceives of, develops, delivers, and manages products for customer use. The Product Manager 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description The Subrogation Professional 2 iIdentifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health ..
Description The Senior Internal Auditor develops, plans and executes internal audits to provide assurance for Puerto Rico's accounting records and the operational activities of Puerto Rico to ensure compliance with the ..
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 Do you enjoy helping those in need? Do you love researching, analyzing medical documents to determine if something was missed? Have you ever considered yourself a detective for medical claims ..
Description Humana is continuing to grow nationwide! We have several new Inbound Contact Representatives openings that will have the pleasure of taking inbound calls from our Medicare Members and provide excellent ..
Job Information Humana Market Leadership Advisor (Managed/Health Care Industry) San Juan, PR in San Juan Puerto Rico Description The Market Leadership Advisor manages the development, operations, and results of a health ..
Job Information Humana Inbound Contacts Representative 2 (Fully Bilingual in English/Spanish) in San Juan Puerto Rico Description The Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or ..
Job Information Humana Grievances & Appeals Representative 3 (Bilingual English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Grievances & Appeals Representative 3 manages client medical denials by conducting ..
... Business Support Professional (Fully Bilingual English/Spanish) San Juan, PR in San ... improving consumer experiences Fully Bilingual English/Spanish . Must be able to ... a Language Proficiency Assessment in..
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 ..
... Appeals Representative 3 (Fully Bilingual English/Spanish) San Juan, PR in San ... Diploma or equivalent Fully Bilingual English/Spanish. Must be able to speak, ... a Language Proficiency Assessment in..
Job Information Humana Call Quality Professional 1 (Bilingual English/Spanish) in San Juan Puerto Rico Description The Call Quality Professional 1 monitors and evaluates the quality of inbound and/or outbound customer service ..
Description The Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. ..
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, Consumer Service Operations is responsible for the daily activities across multiple service functions area. The Supervisor, Consumer Service Operations works within thorough, prescribed guidelines and procedures; uses independent ..
... Contact Representative 3 (FULLY Bilingual English/Spanish) San Juan, Puerto Rico in ... verbal and listening communication skills (English/Spanish) Fully Bilingual - English/Spanish. Must be able to speak, ... PR..