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Description The WEEKEND Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization ..
... drug therapy optimization. Oversee and lead the specialty drug clinical program ... updates, and market event notifications. Lead the analysis and generation of ... initiatives and continuously improve the..
... experience in program management to lead and manage a team of ... problems within department(s), and could lead multiple managers or highly specialized ... with strong ability to influence,..
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Description Humana has articulated a long-term vision to transform from a health insurance company to a health services company distinguished by the prioritization of the health outcomes and care experiences of ..
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 Humana is a Fortune 60 healthcare company with a history of successful innovation and reinvention, with over 50 years as a proven leader and innovator in the health and wellness ..
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 Senior Risk Management Professional a critical member within Humana's Third Party Risk Management Program (TPRM), a 2nd Line of Defense function, will be responsible for maturing our program by ..
Description As Lead Actuary of the Risk Predictive Models team, you have an opportunity to both learn more about predictive analytics and machine learning and to see it become very real ..
Description The Associate Director, Consumer Engagement oversees the enrollment, education, engagement, and activation duties for client groups regardless of segment, and for product where warranted. The Associate Director, Consumer Engagement requires ..
... to enhance the clinical delivery process. The Associate Director, Compliance Nursing ... problems within department(s), and could lead multiple managers or highly specialized ... Responsibilities include: Leads Medicaid operational..
