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Humana $40,600 jobs in Remote

Page 1 of 45 jobs
  • Responsibilities include for this position include:
  • Review Medical Records for compliance with HEDIS measures.
  • Comfort learning/using new system applications.
  • The Quality Improvement Professional 2 implements quality improvement programs for all lines of business including annual program description, work plan, and…
  • The Senior Research Consulting Professional performs basic observational and experimental scientific, technological, health economics and outcomes investigation…
  • The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices.
  • Prepares complex investigative and audit reports.
  • The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims.
  • The Financial Underwriter 2 computes rates for both renewing and prospective moderate to complex group accounts.
  • Bachelor's degree or equivalent experience.
  • The Workforce Management Professional 2 applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and…
  • The Associate Director, Contract Tools, Education, Processes builds templates, standard documentation, policy and protocol, case studies, and disseminating best…
  • The Veteran Community Engagement Manager (VCEM) develops and maintains relationships within the local community to facilitate market engagement and sales…
  • The Medical Director relies on medical background and reviews health claims.
  • The Medical Director work assignments involve moderately complex to complex issues…