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Job Information Humana Quality Audit Professional 2 (Grievance & Appeals) -(FULLY BILINGUAL English/Spanish) Remote, anywhere with-in Eastern Time Zone in Green Bay Wisconsin Description The Quality (Non-Calls) Professional 2 ensures that ..
Description The Grievances & Appeals Representative 4 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
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 Bilingual Medicare Sales Field ... protect member PHI / HIPAA information Must reside within the assigned ... public speaking and presentations Additional Information Upon offer acceptance you..
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 Humana is seeking a Housing Navigator to join the Wisconsin Medicaid Market (iCare) team. The Housing Navigator manages and monitors housing or re-housing services for members which involves orienting all ..
Job Information Humana Grievances and Appeals Representative 3 - KY, WI or PR in Green Bay Wisconsin Description Do you enjoy helping those in need? Do you love researching, analyzing medical ..
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 ..
Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness by guiding members/families toward resources appropriate for the ..
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..
... strategy by collecting broad based information and gathering resources and data ... corrected facility, MD, and diagnosis information Ensure members are picked up ... 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 ..
Description The Bilingual Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further ..
... for bilingual skills; see Additional Information below) Demonstrated experience with providing ... Outlook and MS Teams Additional Information Please be advised, any Humana ... protect member PHI / HIPAA..
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 . 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 Humana/iCare is seeking a Community Engagement Specialist to join our growing team in the Wisconsin Medicaid Market. The Community Engagement Specialist establishes and cultivates the organization's relationships with key community ..
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 ..
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? ..
... 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..
