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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 ..
View More Apply Now College of Arts and Sciences Description: King University, a Christian liberal arts college founded in the Presbyterian tradition and located in the picturesque foothills of East Tennessee, ..
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 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 ..
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 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? ..
View More Apply Now Development/Advancement Description: King University is accepting applications for the full-time position of Administrative Assistant in the Development Office at our Bristol, TN campus. Applications will be accepted ..
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 ..
Description: Bilingual - Spanish Customer Service Representative - CUS001676 This role will be hybrid working remotely and a few days in office per month. Delivers superior customer service while handling a ..
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 changes ..
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 internal ..
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 Bilingual Quality Auditor in Brentwood Tennessee Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
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 wellness ..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Brentwood Tennessee Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience 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 everywhere, ..
Job Information Humana Telephonic Behavioral Health Care Manager in Brentwood Tennessee Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or ..
Description Humana is continuing to grow nationwide! We have several new Bilingual Inbound Contact Representatives openings that will have the pleasure of taking inbound calls from our Medicaid Members and provide ..
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 ..
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 to ..
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 ..
