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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 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 Portsmouth New Hampshire Description The Subrogation Professional 2 identifies, investigates, and collects recoveries from third parties who are legally responsible for..
Job Information Humana Telephonic Behavioral Health Care Manager in Portsmouth New Hampshire Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to..
ResponsibilitiesnThe Senior Linguist Analyst with Peraton Labs will manage the full lifecycle of advanced language exploitation, starting with the curation and collection of country-specific language sources to the dissemination of..
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 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 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..
Job Information Humana Bilingual Quality Auditor in Portsmouth New Hampshire Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of..
Lead Warehouser - BILINGUAL REQUIRED - ( 2300065W ) Description Why Sherwin-Williams Here, we believe there’s not one path to success, we believe in careers that grow with you. Whoever..
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 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..
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..
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 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..
Job Information Humana Social Media Representative 3 - Remote in US in Portsmouth New Hampshire Description The Social Media Representative 3 protects company's brand image by monitoring and addressing social..
About this job Find your commute Company Overview SiteOne associates are customer obsessed, always safe, continuously improving, and having fun! Whether you are experienced in the green industry, a professional..
The role of a Benefit Educator is a critical one to the success of our business. As the face of *** your primary responsibility is to conduct world class enrollment..
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 Manager, Utilization Management RN - Remote in Portsmouth New Hampshire Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication..
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,..
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..
