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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 Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement...
Job Information Humana Subrogation Professional 2-WAH in US in Louisville Kentucky Description The Subrogation Professional 2 identifies, investigates, and collects recoveries from third parties who are legally responsible for paying..
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..
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, 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,..
Alternate Locations: Atlanta, GA (Georgia); Austin, TX (Texas); Bakersfield, CA (California); Baltimore, MD (Maryland); Baton Rouge, LA (Louisiana); Birmingham, AL (Alabama); Boise, ID (Idaho); Boston, MA (Massachusetts); Buffalo, NY (New..
Job Information Humana Manager, Utilization Management RN - Remote in Louisville Kentucky Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of..
Description Responsibilities The Payment Integrity Professional 2 contributes to overall cost reduction, by increasing the accuracy of provider payments in our payer systems, and by ensuring correct claims payment. This..
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 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..
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..
Job Information Humana Social Media Representative 3 - Remote in US in Louisville Kentucky Description The Social Media Representative 3 protects company's brand image by monitoring and addressing social media..
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 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..
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 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..
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..
Admin / Clerical (135) Advanced Practice Registered Nurses / Physician Assistants (501) Allied Health (2702) Executive (62) Nursing Support (1) Operations (152) Physicians/Surgeons (2049) Quality/Risk Management (20) Type Contract (1)..
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..
Description Humana is continuing to grow nationwide! We have several new Bilingual Inbound Contact Representatives openings that will have the pleasure of taking inbound calls from our Medicaid Members and..
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..
