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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 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 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 Bilingual Senior Compliance Professional - Agent Investigations Unit (AIU) ensures compliance with governmental requirements, specifically those governing the sale of Humana plans. The AIU Senior Compliance Professional works..
ESSENTIAL DUTIES & RESPONSIBILITIES:Supervises the day-to-day activities of processing operations and personnel to meet established processing, quality control and animal welfare standards.Ensures activities meet short-term goals established for processing continuity..
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 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..
ADP is hiring a Lead Computational Linguist Are you inspired by transformation and making an impact on the lives of millions of people every day? Are you empathic to client..
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..
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..
Production SupervisorThis position is responsible for assuring all procedures are followed in achieving the highest level or productivity in the most cost efficient manner possible while still maintaining the specification..
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..
Job Information Humana Telephonic Behavioral Health Care Manager in Louisville Kentucky Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve..
HR Supervisoru00A0GENERAL SUMMARY:This position will supervise and coordinate activities of professional level and administrative support employees engaged in employee relations, compensation, benefits, training, employment, labor relations, affirmative action and employment..
Job Information Humana Bilingual Quality Auditor in Louisville Kentucky Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality...
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 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..
