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Description Humana is continuing to grow! We have several new Inbound Contact Representatives openings that will have the pleasure of taking inbound calls from our Medicare Members and provide excellent service ..
Job Information Humana Associate Director, Provider Payment Integrity | ... in Louisville Kentucky Description The Associate Director, Payment Integrity uses technology ... and our financial recovery. The Associate Director, Payment..
Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
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 and ..
Job Information Humana Telephonic Behavioral Health Care Manager in Louisville Kentucky Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or ..
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 health ..
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 flexibility ..
Description The Senior Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Senior Utilization ..
Description The Bilingual Senior Compliance Professional - Agent Investigations Unit (AIU) ensures compliance with governmental requirements, specifically those governing the sale of Humana plans. The AIU Senior Compliance Professional works assignments ..
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 Members ..
Job Information Humana Bilingual Quality Auditor in Louisville Kentucky Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
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 warranted ..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Louisville Kentucky Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience and ..
ADP is hiring a Lead Computational Linguist Are you inspired by transformation and making an impact on the lives of millions of people every day? Are you empathic to client needs ..
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 shine? ..
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, Pre-Authorization ..
