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Senior Accreditation Professional

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**We are ...
Details
Summary
About the job:
seeking a Senior Accreditation Professional who will work in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana.**Role Responsibilities:**+ Serves as subject matter expert on NCQA Health Plan Accreditation Long-Term Services and Supports (LTSS) requirements, advising stakeholders on compliance, and facilitating NCQA LTSS file universe preparation and LTSS file reviews.+ Works closely...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Business Operations Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Medical Director - North Central Region - Medicaid

Humana
Saint Paul, MN
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**Become a part of our caring community and help us put health first**The ...
Details
Summary
About the job:
Medical Director relies on medical background and reviews health claims. The Medical Director (Staff Geriatrician or Physician with Ten (10) Years of Clinical Practice with Older Adults) works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.The Staff Geriatrician or Physician with Ten (10) Years of Clinical Practice with Older Adults (Medical Director) is dedicated full time to the Indiana Pathways program to assist the...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Board Certified
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Utilization Management Administration Coordinator

Humana
Cincinnati, OH
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**Become a part of our caring community and help us put health first**Humana ...
Details
Summary
About the job:
Healthy Horizons in Ohio is seeking a Utilization Management Administration Coordinator 2 who contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as...
Location:
Cincinnati, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries and Administrative Assistants
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
Certifications / Licenses:
ICD-10 / ICD-9
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Medical Director - North Central Region - Medicaid

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**The ...
Details
Summary
About the job:
Medical Director relies on medical background and reviews health claims. The Medical Director (Staff Geriatrician or Physician with Ten (10) Years of Clinical Practice with Older Adults) works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.The Staff Geriatrician or Physician with Ten (10) Years of Clinical Practice with Older Adults (Medical Director) is dedicated full time to the Indiana Pathways program to assist the...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Board Certified
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Data & Reporting Professional, SPARx

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**The ...
Details
Summary
About the job:
Data and Reporting Professional 2 generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Data and Reporting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Data and Reporting Professional 2 integrates data from multiple sources to produce requested or required data elements. Programs and maintains report forms and...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
7
Graphic Literacy
6
Workplace Documents
7
apply
Detailed Job Information

Utilization Management Administration Coordinator

Humana
Dublin, OH
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**Become a part of our caring community and help us put health first**Humana ...
Details
Summary
About the job:
Healthy Horizons in Ohio is seeking a Utilization Management Administration Coordinator 2 who contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We are proud of our Louisville roots and, as...
Location:
Dublin, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries and Administrative Assistants
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
Certifications / Licenses:
ICD-10 / ICD-9
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Senior Accreditation Professional

Humana
Saint Paul, MN
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**Become a part of our caring community and help us put health first**We are ...
Details
Summary
About the job:
seeking a Senior Accreditation Professional who will work in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana.**Role Responsibilities:**+ Serves as subject matter expert on NCQA Health Plan Accreditation Long-Term Services and Supports (LTSS) requirements, advising stakeholders on compliance, and facilitating NCQA LTSS file universe preparation and LTSS file reviews.+ Works closely...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Business Operations Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Medical Director - Northeast Region

Humana
Saint Paul, MN
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**Become a part of our caring community and help us put health first**The ...
Details
Summary
About the job:
Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Board Certified
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Data & Reporting Professional, SPARx

Humana
Saint Paul, MN
Actions
Apply
Save to My Profile
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Report this job
**Become a part of our caring community and help us put health first**The ...
Details
Summary
About the job:
Data and Reporting Professional 2 generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Data and Reporting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Data and Reporting Professional 2 integrates data from multiple sources to produce requested or required data elements. Programs and maintains report forms and...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
7
Graphic Literacy
6
Workplace Documents
7
apply
Detailed Job Information

Business Intelligence Engineer

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**The ...
Details
Summary
About the job:
Business Intelligence Engineer solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Engineer work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Business Intelligence Engineer describes the tools, technologies, applications and practices used to collect, integrate, analyze, and present an organization's raw data in order to create...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Software Developers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
4
apply
Detailed Job Information
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