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Description Responsibilities The Senior Clinical Insights Professional delivers clinical policy insight and information to both internal and external customers for Humana Government Business (HGB). The Senior Clinical Insights Professional will draft ..
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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 ..
Description The Provider Contracting Professional 2 initiates, negotiates, and executes ... initiates, negotiates, and executes LTC provider contracts and agreements for an ... provides LTC health insurance. The Provider Contracting..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, ... executes physician, hospital, and/or other provider contracts and agreements for an ... provides health insurance. The Senior Provider..
Description The Senior Professional, Medicaid Network Strategy will be accountable ... development of Humana Healthy Horizon's (Medicaid) network and provider strategy for its growth markets. ... related to access to..
Job Information Humana Associate Director, Care Management (Florida Medicaid) - Remote, Florida in Tampa Florida Description Humana Healthy Horizons is seeking an Associate Director, Care Management who will lead teams of ..
... The Claims Research & Resolution Professional 2 works with enterprise shares ... enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to ... Humana Gold..
... well-being. We also provide excellent professional development & continued education Responsibilities ... continued education Responsibilities The Senior Provider Installation Professional provides support to provider accounts by responding to inquiries..
... Senior Contract Tools, Education, Processes Professional - Remote in Tampa Florida ... Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy ... Senior Contract Tools, Education, Processes..
... Humana Marketing & Community Engagement Professional in Tampa Florida Description The ... The Marketing & Community Engagement Professional 2 is a boots-on-the-ground collaborator ... The Marketing & Community Engagement..
Description The Senior Compliance Professional ensures compliance with governmental requirements, ... of CenterWell Primary Care Organization provider clinics including serving as a ... care programs. The Senior Compliance Professional work..
... planning. Understands own work area professional concepts/standards, regulations, strategies and operating ... guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. The ... by our comprehensive contract. Visit..
... their most productive. Humana's Florida Medicaid RVP, Operations (COO) will be ... of operations for Humana's Florida Medicaid and Long-Term Care plan and ... Management, Quality, Network, Member &..
Job Information Humana Provider Contracting Professional 2 - Behavioral Health/Medicaid in Tampa Florida Description The ... in Tampa Florida Description The Provider Contracting Professional 2 initiates, negotiates, and executes .....
Description The Provider Contracting Professional initiates, negotiates, and executes physician, ... executes physician, hospital, and/or other provider contracts and agreements for an ... that provides health insurance. The Provider Contracting..
Job Information Humana Medical Director - Florida Medicaid in Tampa Florida Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Provider Contracting Professional 2 - Work at Home ... Managed Long Term Care (MLTC) Medicaid providers in specified regions. Manages ... providers in specified regions. Manages provider..
Description The Senior Process Improvement Professional analyzes, and measures the effectiveness ... improvements. The Senior Process Improvement Professional work assignments involve moderately complex ... variable factors. Responsibilities The Senior Provider..
Description Humana Healthy Horizons is seeking a Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, ..
... Medical Directors will learn KY Medicaid requirements, and will understand how ... related to care of a Medicaid population (TANF and expansion populations). ... industry including Medicare Advantage, Managed..
Description The CCM Compliance Professional 2 ensures compliance with governmental ... contractual requirements. The CCM Compliance Professional 2 work assignments are varied ... action. Responsibilities The CCM Compliance Professional 2..