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Description The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both..
Job Information Humana Manager, Quality Compliance in Newellton Louisiana Description Humana Healthy Horizons in Louisiana is seeking a Manager, Quality Improvement who will implement and monitor quality improvement program components,..
Description A Peer Support Specialist (Care Management Support) is a person in recovery from a behavioral health condition (mental health, substance use, or co-occurring) who provides mentoring, guidance, and support..
Company Name: Kroger Stores Position Type: Employee FLSA Status: Non-Exempt Our primary focus is to create an uplifting customer experience through exceptional service. We are looking for friendly and engaged..
Description The Community Health Worker/Care Management Support Professional 1 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve..
Description The Provider Relations/Engagement Professional 2 develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the..
Description The Field Care Manager, Behavioral Health 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with..
Job ID 21000MSKAvailable Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The..
Job ID 21000F79Available Openings 1Position Specific Information This position has a Sign On Bonus totaling $5000.00. 1/2 will be paid after 90 days of employment and the balance after one..
Description The Care Management Support Assistant 2 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 Transition Coordinator (Care Coach 1) assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources..
Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization..
Description The Social Determinants of Health (SDOH) Coordinator understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is..
