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Description The Care Management Support Assistant 2 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..
Job Information Humana Bilingual Spanish RN Care Manager--Compact License Required-WAH Nationwide in Charleston West Virginia Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates..
Job Information Humana RN Care Manager--Compact License Required-WAH Nationwide in Charleston West Virginia Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs..
Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of..
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..
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 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..
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 Consumer Engagement Professional 2/Group Medicare Member Engagement Professional oversees the enrollment, education, engagement, and activation duties for client groups regardless of segment, and for product where warranted. The..
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,..
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..
Professional, Web Content & French CA Translations (Remote) Date: May 31, 2022 Location: Remote, US Company: Under Armour Under Armour has one mission: to make you better. We have a..
Job Information Humana Telephonic Behavioral Health Care Manager in Charleston West Virginia Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements 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..
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 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 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..
Description The Inbound Contacts Representative represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative performs varied activities and moderately complex administrative/operational/customer support assignments. Performs..
Description The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management..
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..
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..
