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18 fresh jobs found
Medical Director--Claims Management
Remote US, United States Humana logo Humana
Inpatient care Clinical patient care Computer-Based Review Outpatient services Home health services Grievance and appeals processes Clinical reference materials CMS policies Post-acute care +87
Exec Senior Full Time
USD 223K+
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Accreditation Manager
Remote US, United States Humana logo Humana
NCQA Accreditation Continuous process improvement Team Engagement Health Plan Experience Judgement Functional strategies NCQA LESS Accreditation +44
Mid Full Time
USD 94K+
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Senior Accreditation Professional
Remote US, United States Humana logo Humana
NCQA Accreditation Long Term Services and Supports Team Engagement Continuous process improvement Health Plan Experience Functional strategies Long Term Care Judgement LESS +46
Senior Mid Full Time
USD 78K+
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Medical Director - Medicaid N. Central
Remote US, United States Humana logo Humana
Health claims review Computer-Based Review Post-acute services Grievance and appeals processes Post-acute care Humana policies Family practice Clinical group practice management Medical interpretation +92
Exec Senior Full Time
USD 223K+
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Medical Director - Care Plus
Remote US, United States Humana logo Humana
Grievance processes Health claims review Outpatient services Grievance and appeals processes Post-acute care Clinical group practice management Commercial health insurance Hospitalist Inpatient rehabilitation +90
Exec Senior Full Time
USD 223K+
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Medical Director - Mid West Region
Remote US, United States Humana logo Humana
Computer-Based Review Outpatient services Grievance and appeals processes Post-acute care Humana policies Hospitalist Medical interpretation National Guidelines Family practice +83
Exec Mid Full Time
USD 223K+
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Sr IT Project Manager
Remote US, United States Humana logo Humana
Data Center Migrations Direct Connect Express Routes IBM DBMS IPsec CICS DWDM Judgement Statistical software +82
Senior Full Time
USD 104K+
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Medical Director - Southeast Region
Remote US, United States Humana logo Humana
Computer-Based Review Health claims review Post-acute services Grievance and appeals processes Outpatient services Inpatient rehabilitation Post-acute care Clinical group practice management Commercial health insurance +87
Exec Senior Full Time
USD 223K+
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Medical Director - Gulf South
Remote US, United States Humana logo Humana
Post-acute services Grievance and appeals processes Community Groups Outpatient services Clinical group practice management Commercial health insurance Inpatient rehabilitation Post-acute care Humana policies +88
Exec Senior Full Time
USD 223K+
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Medical Director - Mid West Region
Remote US, United States Humana logo Humana
Computer-Based Review Community Groups Outpatient services Grievance and appeals processes Inpatient rehabilitation Commercial health insurance Clinical group practice management Post-acute care Humana policies +83
Exec Senior Full Time
USD 223K+
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Behavioral Health Medical Director - Medicaid
Remote US, United States Humana logo Humana
Computer-Based Review CGX Community Groups Clinical reference materials CMS policies Medical background MCG Medical Director Clinical evaluation +48
Exec Senior Full Time
USD 223K+
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Lead Digital Product Manager - CenterWell Experiences
Remote US, United States Humana logo Humana
AEM Digital Product Management Judgement Product lifecycle management Home Health Digital products Efficiency Technical Strategy Azure DevOps +48
Senior Full Time
USD 126K+
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Manager, Care Management (Maternal-Child Health)
Work at Home - Virginia, United States Humana logo Humana
Clinical Intervention Maternal-Child Health Face-to-face assessments Interpreting Data Operational Leadership Cultural Competence Judgement Health and wellness Rating +66
Mid Full Time
USD 25K+
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Medical Director- South Central
Remote US, United States Humana logo Humana
Community Groups Outpatient services Grievance and appeals processes Post-acute services Clinical group practice management Inpatient rehabilitation Post-acute care Commercial health insurance Humana policies +86
Exec Senior Full Time
USD 223K+
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Medical Director - Pacific SW
Remote US, United States Humana logo Humana
Health claims review Community Groups Outpatient services Grievance and appeals processes Clinical group practice management Commercial health insurance Inpatient rehabilitation Post-acute care Humana policies +84
Exec Senior Full Time
USD 223K+
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Medical Director - Northeast Region
Remote US, United States Humana logo Humana
Community Groups Outpatient services Post-acute services Grievance and appeals processes Clinical group practice management Commercial health insurance Post-acute care Inpatient rehabilitation CMS policies +88
Exec Senior Full Time
USD 223K+
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Medical Director - Southeast Region
Remote US, United States Humana logo Humana
Health claims review Community Groups Outpatient services Post-acute services Grievance and appeals processes Clinical group practice management Commercial health insurance Inpatient rehabilitation Humana policies +84
Exec Senior Full Time
USD 223K+
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Supervisor, UM Administration - Medicare
Remote US, United States Humana logo Humana
Ethical Decision Making Operational Concepts CGX Microsoft Office Word Judgement Supervisory experience Consumer Experiences Verbal and written communication Supervisory +41
Mid Full Time
USD 71K+
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