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Job Information Humana Medical Claims Processing Representative 2 in Jersey City New Jersey Description The Medical Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via..
Description Are you someone who is passionate about helping Sales Agents learn through facilitation and development? Then we have a job for you! Humana is in search for our next..
Description The Bilingual Grievances & Appeals Representative 3 manages client concerns by conducting and responding to complaints, grievances and appeals in a consistent fashion, adhering to all regulatory, accreditation and..
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 . 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 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..
Interpreter/Translator (Staten Island) #25-53 Staten Island, New York, United States Deadline is 3:00 PM EST for Date Listed Apr 04, 2025 Job Description The Legal Aid Society’s Criminal..
Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST states Responsibilities The Bilingual..
Posted: 31-May-23 Location: Morristown/NJ/USA Salary: Open Categories: General Nursing Required Education: High School Internal Number: 125051865 Overview Atlantic Health System is seeking a per-diem Registered Nurse for the Ambulatory Service..
Job Code 2168840 Optum in the tri-state region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group) offers an interconnected network that enables us to work collaboratively to better..
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 Supervisor, Grievances & Appeals manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if a grievance, appeal, or further request is..
Job Information Humana Telephonic Behavioral Health Care Manager in Jersey City New Jersey Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements..
Full time/Part time: Full-time Location: Newark Categories: Administrator Members of the Housing Justice Corps will be part of a network of advocates, some of whom will work in the Center..
Description Responsibilities Humana's Corporate Marketing organization is seeking 2 Bilingual Production Professionals that are fluent in both English and Spanish to join the Humana Translation team supporting Medicaid growth and..
Description As an Engagement Specialist you will be responsible for contributing to and delivering on Humana's strategy in community based engagement. You will be responsible for effectively promoting our Medicare..
Job Information Humana Bilingual Quality Auditor in Jersey City New Jersey Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards..
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 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..
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 Data entry of member updates/provider..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the..
Job Information Humana Telephonic Behavioral Health Care Manager in Livingston New Jersey Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to..
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..