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Description Humana is continuing to grow! We have several new Inbound Contact Representatives openings that will have the pleasure of taking inbound calls from our Medicare Members and provide excellent service ..
Job Information Humana Social Worker-MSW and licensure required- Telephonic Behavioral Health-SNP- WAH Nationwide in Tampa Florida Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and ..
Description Humana is continuing to grow nationwide! We have several new Inbound Contact Representatives openings that will have the pleasure of taking inbound calls from our Medicare Members and provide excellent ..
Description The Compliance (UM) Professional 2 conducts and summarizes compliance audits. The Compliance (UM) Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses ..
Description The Associate Director, Grievances & Appeals manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request ..
Description The Quality (Non-Calls) Professional 2 ensures that products meet certain standards of quality. The Quality (Non-Calls) Professional 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description The Subrogation Professional 2 iIdentifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health ..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Description The Care Management Support Assistant 2 (CMSA2) 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 ..
Description The Senior Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Senior Compliance ..
Description The Product Manager 2 Conceives of, develops, delivers, and manages products for customer use. The Product Manager 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Supervisor, Grievances & Appeals ..
Description The Consumer Engagement Professional 2 oversees the enrollment, education, engagement, and activation duties for client groups regardless of segment, and for product where warranted. The Consumer Engagement Professional 2 work ..
Description The Field Care Manager Nurse 2 assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate ..
Job Information Humana Care Coach 1 - Bilingual (English/Spanish) - Tampa, FL in Tampa Florida Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain ..
Description The Enrollment Representative 3 processes applications from members, enrolls them on company platforms, and transmits enrollment to Center for Medicare and Medicaid Services. The Enrollment Representative 3 performs advanced administrative/operational/customer ..
Description The Bilingual Claims Research and Resolution Representative 2 address customer needs which may include complex financial recovery questions, and resolving issues. Records details of inquiries, comments or complaints, transactions or ..
