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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 ..
Description The Bilingual Claims Research and Resolution Representative 2 address customer needs which may include complex financial recovery questions, and resolving issues. Records details of inquiries, comments or complaints, transactions or ..
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 ..
Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Supervisor, Grievances & Appeals ..
Description Responsibilities The Payment Integrity Professional 2 contributes to overall cost reduction, by increasing the accuracy of provider payments in our payer systems, and by ensuring correct claims payment. This position ..
Job Information Humana Subrogation Professional 2-WAH in US in Newport Rhode Island Description The Subrogation Professional 2 identifies, investigates, and collects recoveries from third parties who are legally responsible for paying ..
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 ..
Job Information Humana RN Care Manager--Compact License Required-Spanish Bilingual strongly preferred-WAH Nationwide in Newport Rhode Island Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates ..
Job Information Humana Subrogation Professional 2 Remote/WAH in USA in Newport Rhode Island Description The Subrogation Professional 2 identifies, investigates, and collects recoveries from third parties who are legally responsible for ..
Job Information Humana Senior Clinic Emerging Markets Trainer, Merger & Acquisition - Remote in Newport Rhode Island Description The Senior Clinic Emerging Markets Trainer creates and implements processes and programs to ..
Job Information Humana Utilization Management Administration Coordinator - Remote in Newport Rhode Island Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities ..
Job Information Humana RN Care Manager--Compact License Required-Spanish Bilingual a plus-WAH Nationwide in Newport Rhode Island Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates ..
Job Information Humana Bilingual Spanish RN Care Manager--Compact License Required-WAH Nationwide in Newport Rhode Island Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' ..
Description The Outbound Contacts Representative 3 represents the company by making outbound contacts to members and/or providers regarding a variety of issues. The Outbound Contacts Representative 3 performs advanced administrative/operational/customer support ..
Job Information Humana RN Care Manager--Compact License Required-WAH Nationwide in Newport Rhode Island Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and ..
Description The Subrogation Professional 2 iIdentifies, 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 ..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Newport Rhode Island Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience ..
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 Supervisor, Grievances & Appeals - Remote, EST or CST in Newport Rhode Island Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic ..
