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Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
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 ..
Job Information Humana Grievances & Appeals Representative 3 (Fully Bilingual English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Grievances & Appeals Representative 3 manages client medical denials by ..
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 on ..
Description The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs administrative/operational/customer support/computational tasks. Typically works within a framework ..
Job Information Humana Care Manager, Telephonic Nurse 2/RN - San Juan, Puerto Rico in San Juan Puerto Rico Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
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 facilitate ..
Job Information Humana Care Manager, Telephonic Nurse 2 (Fully Bilingual RN with Clinical exp.) - WAH Puerto Rico in San Juan Puerto Rico Description The Care Manager, Telephonic Nurse 2 , ..
... Relationship Manager /Travel 100% - Bilingual (English/Spanish) Remote Puerto Rico in ... will be considered on a case by case basis. Requests for these exemptions ... of work. Preferred..
Job Information Humana Call Quality Professional 1 (Bilingual English/Spanish) in San Juan Puerto Rico Description The Call Quality Professional 1 monitors and evaluates the quality of inbound and/or outbound customer service ..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... Inbound Contacts Representative 2 (Fully Bilingual in English/Spanish) in San Juan ... medical, dental & vision benefits, case management, compliance requirements and more. ... performed for English and or..
Description Do you enjoy helping those in need? Do you love researching, analyzing medical documents to determine if something was missed? Have you ever considered yourself a detective for medical claims ..
Job Information Humana Grievances & Appeals Representative 3 (Bilingual English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Grievances & Appeals Representative 3 manages client medical denials by conducting ..
Job Information Humana Care Manager, Telephonic Nurse 2 (Fully Bilingual RN with Clinical exp.) - San Juan, Puerto Rico in San Juan Puerto Rico Description The Care Manager, Telephonic Nurse 2 ..
Job Information Humana Care Management Support Assistant 3/ Inbound Call Center - Remote, Puerto Rico in San Juan Puerto Rico Description As Care management Support Assistant 3, in Case Management Department ..
Job Information Humana RN Care Manager, Telephonic Nurse (Bilingual) - Puerto Rico in San Juan Puerto Rico Description This is a Work-At-Home position located in Puerto Rico. You must be fully ..