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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 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..
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..
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..
Job Location CT - Bridgeport AIC - Bridgeport, CT Position Type Full Time Education Level Bachelors Degree Travel Percentage License Required Job Shift Various Shift Hours Bilingual Case Manager, AIC..
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..
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..
:,ActualValueFromSolar:null},{QuestionName:External Title,AnswerValue:International Assignment /EAC Consultant III - Remote,VerityZone:formtext4,QuestionType:text,ActualValueFromSolar:null},{QuestionName:Employment Type,AnswerValue:Full-time ,VerityZone:formtext16,QuestionType:radio,ActualValueFromSolar:null},{QuestionName:About Us,AnswerValue:u003cpu003eu003cspan style=font-size: 16px\u003eu003cspan style=font-family: Verdana, Geneva, sans-serif\u003eWith more than 60 years in operation, u003ca href=https://www.cartus.com/ target=_blank\u003eCartusu003c/au003e offers a broad range..
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..
Level Entry Job Location Torrington AIC (CT) - Torrington, CT Position Type Full Time Education Level Bachelors Degree Salary Range $20.00 Hourly Travel Percentage License Required Job Shift First Shift..
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..
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..
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,..
Job Information Humana Medical Claims Processing Representative 2 in Bridgeport Connecticut Description The Medical Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via paper or..
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..
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..
Job Information Humana Telephonic Behavioral Health Care Manager in Bridgeport Connecticut Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve..
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..
Job Information Humana Bilingual Quality Auditor in Bridgeport Connecticut Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality...
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..
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..
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..
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..