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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..
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..
ACT Vocational Specialist (Full Time) Location: Woonsocket, RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof of vaccination..
Medical Assistant (Full Time) Location: Woonsocket, RI We are hiring an organized, motivated, respectful professional Medical Assistant to work in our Community Support program providing support and care coordination to..
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..
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..
Job Information Humana Bilingual Quality Auditor in Newport Rhode Island Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of..
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 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,..
Vocational Specialist ACT (Full Time) Location: Woonsocket, RI The ACT Team is conducting a search for a full time Vocational Specialist to begin immediately. ACT is a program to help..
ACT Substance Use Specialist (Full Time) Location: Woonsocket, RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof of..
CCBHC Vocational Specialist (Full Time) Location: Woonsocket, RI Our Community Support Program is searching for a Vocational Specialist to support individuals with co-occurring mental health and substance use challenges in..
Master's Rehabilitation Specialist (Full Time) Location: Woonsocket, RI Our Integrated Community Treatment Team (ICTT) is seeking a full-time Masters Rehabilitation Specialist to start immediately. In behavioral health care, integrated care..
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..
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 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..
Job Description CVS Health has an exciting new opportunity for a Bilingual Customer Care Representative. The Customer Care Contact Center is actively hiring service focused professionals fielding inbound contacts from..
Job Information Humana Telephonic Behavioral Health Care Manager in Newport Rhode Island Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to..
Masters Level Clinician Co-Occurring (Full Time) Location: Woonsocket, RI If you are a Masters Level Clinician with a Recovery focus, then we have a position for you in our Community..