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Description The Supervisor, Care Management Support 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 Medical Claims Processing Representative 2 in Cincinnati Ohio Description The Medical Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. ..
Job Information Humana Grievances and Appeals Representative in Cincinnati Ohio Description Do you enjoy helping those in need? Do you love researching, analyzing medical documents to determine if something was missed? ..
Description Pharmacy Technician or Pharmacy Tech in Training - Arizona, Florida, Ohio, and Texas. Our DOD Skill Bridge Internship program will help you obtain your Pharmacy Technician in Training or Pharmacy ..
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 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 ..
... for bilingual skills; see Additional Information below) Proficiency with Microsoft Office ... Outlook and MS Teams Additional Information Please be advised, any Humana ... protect member PHI / HIPAA..
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 ..
Job Information Humana Bilingual Quality Auditor in ... Professional 2 Analyze Grievance/Appeals case information to ensure compliance of all ... Assessment in English/Spanish. See Additional Information on testing. Preferred Qualifications..
Job Information Humana Telephonic Behavioral Health Care ... protect member PHI / HIPAA information. Additional information The department prefers candidates that ... working in the field. Additional information As part..
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 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 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 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, ..
... Enters and maintains pertinent clinical information in various medical management systems. ... guidelines. Experience in leadership. Additional Information While the normal operating hours ... as business needs dictate. Additional..
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 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 ..
... for bilingual skills; see Additional Information below) Demonstrated experience with providing ... Outlook and MS Teams Additional Information Please be advised, any Humana ... learning and keeping protected health..
... English and Spanish (see Additional Information below) Residency within the continental ... Word and MS Teams Additional Information Please be advised, any Humana ... protect member PHI / HIPAA..
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 Grievances ..
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 denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if a grievance, appeal, or further request is warranted ..
