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Description The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management..
Description The Inbound Contacts Representative represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative performs varied activities and moderately complex administrative/operational/customer support assignments. Performs..
Professional, Web Content & French CA Translations (Remote) Date: May 31, 2022 Location: Remote, US Company: Under Armour Under Armour has one mission: to make you better. We have a..
Description The Bilingual Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or..
Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and..
Description The Care Management Support Assistant contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal..
We are looking for a skilled Data Scientist with expertise in linguistics and data modeling to join our team. The ideal candidate will have a strong background in statistics, programming,..
Job Information Humana Medical Claims Processing Representative 2 in Washington District Of Columbia Description The Medical Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor,..
Description The Subrogation Professional II identifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides..
Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Humana, we want to help people..
Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness by guiding members/families toward resources appropriate for..
Description Are you passionate about contributing to the well-being of the Medicare population? Are you looking for a role that will let your creative ideas, relationship management and sales ability..
Description The Grievances & Appeals Representative 4 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances &..
Medical Interpreter - Spanish/English - PRN','230001D9','!*!Under supervision, The Interpreter/Translator will provide language interpretation and translation services to patients and their families in critical, acute,or chronic medical situations as needed. Will..
Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid..
HSCHC Physical Therapist','230000LH','!*!The Physical Therapist administers physical therapy treatments as ordered by a physician and in accordance with accepted practices of physical therapy. He/she is responsible for evaluating, planning and..
Job Information Humana Bilingual Quality Auditor in Washington District Of Columbia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards..
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..
Job Information Humana Telephonic Behavioral Health Care Manager in Washington District Of Columbia Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements..
Description . Responsibilities The Process Improvement Lead researches best business practices within and outside the organization to establish benchmark data. This individual collects and analyzes process data to initiate, develop..
Description The Enrollment Representative 3 processes applications from members, enrolls them on company platforms, and transmits enrollment to Center for Medicare and Medicaid Services. Responsibilities Enrollment Representative 3 Reviews reports..
