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Description The Risk Management Lead identifies and analyzes potential sources of loss to minimize risk. The Risk Management Lead works on problems of diverse scope and complexity ranging from moderate to ..
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 ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 in Montpelier Vermont Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and ..
... 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 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 Care Manager, Telephonic Behavioral Health 2 - Remote, US in Montpelier Vermont Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the ..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Montpelier Vermont Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can ..
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 ..
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 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 UM Medical Director - Conviva in Montpelier Vermont Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
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 ..
... 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 Humana's technology environment has pivoted from a centralized model over the last several years to a more federated model. This trend will continue and accelerate to the point where Humana's ..
Job Information Humana Telephonic Care Manager in Montpelier Vermont Description The Telephonic Care Manager will be part of the Humana Military Case Management team; providing a comprehensive, holistic approach for Behavioral ..
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 ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Montpelier Vermont Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to lead ..
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 ..
Immigration Paralegal (Remote) Date: Dec 17, 2022 Location: Remote, US Company: Under Armour Under Armour has one mission: to make you better. We have a commitment to innovation that lies at ..
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 ..
