Humana $40,600 jobs in Remote
- 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…
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