Welcome to Humana, a leading healthcare company dedicated to improving the lives of our members. We are currently seeking a highly motivated and detail-oriented Claims Research & Resolution Representative to join our team. In this role, you will be responsible for investigating and resolving complex claims issues, ensuring accurate and timely payments to our members … Read more
Become a part of our caring community and help us put health first The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members’ needs and requirements to achieve and/or maintain optimal wellness by guiding members/care givers toward and facilitates interaction with resources appropriate for the care and wellbeing of members… … Read more
Welcome to Humana! We are currently seeking a highly motivated and customer-oriented individual to join our team as a Provider Call Center Inbound Contacts Representative. In this role, you will have the opportunity to make a positive impact on the lives of our members and providers by providing exceptional customer service and support. As a … Read more
Become a part of our caring community and help us put health first The Claims Review Representative 3 makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate … Read more
The Telephonic Care Manager (Autism Care Navigator) serves as a primary advocate for assigned beneficiaries receiving care under the Autism Care Demonstration (ACD). The ASN (Autism Care Navigator) collaborates and oversees the assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s comprehensive health needs through… communication and available … Read more
Become a part of our caring community and help us put health first The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments… Job Description Location: Work at home in FL, IN, … Read more
Become a part of our caring community and help us put health first The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request is warranted and then delivers final determination based on trained skillsets and/or … Read more
Become a part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of… the appropriate … Read more
Become a part of our caring community and help us put health first Humana Healthy Horizons in Florida is seeking a Provider Engagement Professional to join the Florida Medicaid Market Team. In this role, you will develop and grow positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality … Read more
Become a part of our caring community and help us put health first If you are a problem solver, resourceful, and looking to make a difference for your family as well as others, we want you on the Humana Government Business team! Help us deliver exceptional experiences to our TRICARE members as a Work from … Read more