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UM Appeals Nurse 2

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**The ...
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About the job:
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 courses of action.The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies,...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Associate's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
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Detailed Job Information

Market Consultation/Partnership Professional

Humana
Delaware, OH
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at Humana in Dover, Delaware, United States Become a part of our caring ...
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community and help us put health first The HQRI Provider Support Team ( PST ) Market Consultation/Partnership Professional 2 creates content and deploys training to provider facing associates on our market teams. The Market Consultation/Partnership Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Market Consultation/Partnership Professional 2 engages and partners with market associates and corporate teams to drive...
Location:
Delaware, OH
Job Type:
Full-Time
Permanent
Occupation:
Training and Development Specialists
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
7
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Care Management Support - Wellness Information Navigator

Humana
Cincinnati, OH
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Job Information Position Type: Full Time Certified Age-Friendly Become a ...
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part of our caring community and help us put health first The Care Management Support Professional 1 Wellness & Information Navigator (WIN) contributes to administration of care management. The individual in this role provides non-clinical support to the assessment and evaluation of enrollees' needs and requirements to achieve and maintain an optimal wellness state by guiding enrollees and their families toward and facilitate interaction with resources appropriate for the care and wellbeing. This role’s work assignments...
Location:
Cincinnati, OH
Job Type:
Full-Time
Permanent
Occupation:
Social and Human Service Assistants
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
4
apply
Detailed Job Information

Data and Reporting Professional

Humana
Florida, OH
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Become a part of our caring community and help us put health first The Data ...
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About the job:
and Reporting Professional 2 supports CenterWell Specialty Pharmacy’s Pharma Reporting Team related to clinical and payer reporting. This is an opportunity in a growing environment to support clinical outcome data, presentations, Power BI analytics along with payer reporting requirements. 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...
Location:
Florida, OH
Job Type:
Full-Time
Permanent
Occupation:
Clinical Data Managers
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
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Detailed Job Information

Director, Strategy Advancement

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**The ...
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About the job:
Director, Enterprise Transformation directs and oversees a team of project management, process improvement, change management, and learning and design professionals supporting multiple high-priority projects. This role requires effective prioritizing of capacity based on value to the Medicare-Medicaid organization. Being effective in this role requires a natural aptitude for developing and maturing capabilities, articulating and measuring results and value, and building strong, trusting partnerships across the...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Managers, All Other
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
Certifications / Licenses:
Project Management Professional
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Lead Product Manager - Salesforce Health Cloud

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**The ...
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About the job:
Lead Product Manager Conceives of, develops, delivers, and manages products for customer use. The Lead Product Manager works on problems of diverse scope and complexity ranging from moderate to substantial.The Lead Product Manager Leads all phases of the product life cycle, from inception to introduction into the marketplace, by developing products to meet specific customer needs and achieve specific cost and success outcomes. Once products are launched, monitors efficacy of products and uses customer and business...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Marketing Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
7
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Enterprise Service Desk Lead - IT

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**Are ...
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About the job:
you looking for an opportunity to be an integral part of an IT Service Desk transformation? The ideal candidate will have at least 5 years' experience as an IT Service Desk Leader with experience managing and leading service desk teams in an enterprise environment. This candidate will also have exceptional communication skills, and ideally, ITIL/Six Sigma/or other process related certifications. This role will service internal Humana associates so, it is imperative to have direct Service Desk experience in a high-volume...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Computer User Support Specialists
Career Level / Education:
Associate's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
Certifications / Licenses:
Certified Scrum Master
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
4
apply
Detailed Job Information

National Account Executive

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**Are ...
Details
Summary
About the job:
you passionate about contributing to the well-being of the Medicare population? Would you like to play an integral and strategic part in the overall success of a team? If so, the National Account Executive is responsible for managing all available resources to our FMO partners to help achieve sales growth, improve results and operational goals within the assigned market while also helping to coordinate on a national level. The National Account Executive - FMO develops and maintains relationships with small and...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Insurance Sales Agents
Career Level / Education:
High school diploma or equivalent
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
State insurance license
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Program Delivery Professional 2

Humana
Columbus, OH
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**Become a part of our caring community and help us put health ...
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About the job:
first**Healthcare Quality Reporting & Improvement (HQRI) is an organization responsible for improving health outcomes and advancing the care experience of our members and provider partners through integrated risk adjustment (RA) and quality (Stars) solutions that leverage data and technology to empower members, providers, and Humana.The Risk Adjustment Prospective Provider Programs organization within HQRI delivers a portfolio of products to support physicians in providing optimal patient care and improving the accuracy of their...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Business Operations Specialists, All Other
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Actuarial Analyst, Valuation

Humana
Columbus, OH
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**Become a part of our caring community and help us put health first**The ...
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Summary
About the job:
Actuarial Analyst 2 will support financial reporting for the company's insurance businesses, primarily focused on claim reserves and other balance sheet liabilities.The Actuarial Analyst 2 will support financial reporting for the company's insurance businesses, primarily focused on claim reserves and other balance sheet liabilities. Activities include:+ Execute analysis of unpaid claims and other reserves under the supervision of experienced credentialed actuaries.+ Grow your technical skillset by building and enhancing...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Actuaries
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Actuarial Exams
Workkeys
Applied Math
7
Graphic Literacy
6
Workplace Documents
7
apply
Detailed Job Information
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