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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 ..
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Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Job Information Humana Medical Director - National Medicare Team in Honolulu Hawaii Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Honolulu Hawaii Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special Investigations ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Honolulu Hawaii Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
Job Information Humana Medical Director - Florida Medicaid in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana FP&A Lead, Medicaid Market in Honolulu Hawaii Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of ..
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 ..
Job Information Humana UM Medical Director - Conviva in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Medical Director - S. Florida in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
