Humana

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 The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. The Claims Processing Representative 2: • Determines whether to return, deny, or pay claims following organizational policies and procedures • Claims Processing repetition Use … Read more

Become a part of our caring community and help us put health first The Network Operations Coordinator 3 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. The Network Operations Coordinator 3 performs advanced administrative/operational/customer support duties that require independent initiative and … Read more

Become a part of our caring community and help us put health first The Data and Reporting Analyst will be responsible for a wide array of provider partner and membership performance reports. This role will be responsible for tracking our financial performance, value-based loading and various ad-hoc initiatives. This role will also work with a … Read more

Become a part of our caring community and help us put health first We are seeking a Senior Quality Measurement Professional with expertise in clinical quality measurement to join a team focused on driving better outcomes and more cost-effective care for our 5 million Medicare members… Location: remote The Senior Quality Measurement Professional will support … Read more

Become a part of our caring community and help us put health first Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Conviva, a wholly owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead … Read more

Become a part of our caring community and help us put health first Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy Organization to support our Markets with delivery of benefits to Member’s. This is a unique opportunity for a motivated individual with a track record of achieving results to lead an … Read more

Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Provider Education & Outreach Representative who is responsible for the day-to-day front line relationship management of network providers for Humana’s Healthy Horizons in Indiana, as well as responsible for provider onboarding, training, education, responding … Read more