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Description The 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, Utilization Management Nursing works within ..
Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Billings Montana Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to lead ..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Billings Montana Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can ..
Description The Associate Director, Cloud Network Architecture will design, provide vision and strategy, develop, and execute Humana's Cloud Network architecture and environments. This is a management and leadership position that will ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Billings Montana Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the ..
Job Information Humana UM Medical Director - Conviva in Billings Montana Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
... changes that assure compliance with regulatory and contract obligations. Coordinates business ... and apply laws, regulations, and regulatory guidance for Pharmacy Benefits and ... issues, conduct research, and provide..
Description The IT Compliance Professional audits the most complex new and existing information systems applications to ensure that appropriate controls exist, that processing is efficient and accurate, and that information systems ..
Description The IT Compliance Professional 2 audits the most complex new and existing information systems applications to ensure that appropriate controls exist, that processing is efficient and accurate, and that information ..
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 Compliance (UM) Coordinator 2 in Billings Montana Description The Compliance (UM) Coordinator 2 conducts and summarizes compliance audits. The Compliance (UM) Coordinator 2 performs varied activities and moderately ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 in Billings Montana Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and ..
Description The Associate VP, Network Engineering will design, develop, execute and operate Humana's next generation Network infrastructure capability. This position will provide executive leadership to a team of 50 FTEs and ..
Job Information Humana Telephonic Care Manager in Billings Montana Description The Telephonic Care Manager will be part of the Humana Military Case Management team; providing a comprehensive, holistic approach for Behavioral ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
... Professional creates awareness of current regulatory issues and ensures compliance of ... as follows: Monitor and analyze regulatory requirements to assess contract language ... initiatives, administrative practices, and applicable..
Description The Provider NetworkSenior Network Operations Professional works with the Network Operations lead to oversee the plan's strategic opportunity for growth, audit/survey analysis, action plan oversight, implementation and coordination, provider services ..
