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Strategic Project Manager - Medicaid Capture Management

Humana
Located in Ohio
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data-type="string"> Description : **Become a part of our caring community** ...
Details
Summary
About the job:
The Medicaid Capture Management team’s purpose is to successfully position Humana to enter new markets enabling the future of the business. As a centrally positioned strategic function this team coordinates with growth partners across the enterprise and industry to accelerate product strategy and define the operating model for new markets. We deliver value through detailed research, data-driven insights, strategic planning, structured problem solving, and project management rigor. The Strategic Project Manager plays a...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Project Management Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Community Health Worker 1

Humana
Located in Ohio
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data-type="string"> Description : **Become a part of our caring community** ...
Details
Summary
About the job:
The Community Health Worker1contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Community Health Worker's work assignments are often straightforward and of moderate complexity. Humana's Community Health Workers (CHW) serve as members of our...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
De jobs
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Quality Improvement Professional

Humana
Located in Ohio
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data-type="string"> Description : **Become a part of our caring community** ...
Details
Summary
About the job:
Humana Illinois Market is seeking a Quality Improvement Professional who analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable, and quantifiable business process improvements. The Quality Improvement Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Some experience in project management is also desired. In this role, the professional must understand department, segment,...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
De jobs
Certifications / Licenses:
Project Management Institute
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Director - OneHome

Humana
Columbus, OH
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**Become a part of our caring community**The Medical Director relies on ...
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Summary
About the job:
fundamentals of CMS Medicare Guidance on following and reviewing Home Health, SNF, DME, dual Medicare/Medicaid requests. The Medical Director reviews and determines whether healthcare services provided by other healthcare professionals align with national guidelines, CMS requirements, Humana policies, clinical standards, and applicable contracts.The Medical Director evaluates the medical necessity of healthcare services, ensuring decisions comply with regulatory and organizational standards. The role requires interpreting...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
N/A
From:
US.jobs
Certifications / Licenses:
Board Certified
Medical License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Clinical Policy Operations Professional 2

Humana
Columbus, OH
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**Become a part of our caring community**The Clinical Policy Operations ...
Details
Summary
About the job:
Professional 2 provides operational support to clinical pharmacists for the implementation, maintenance, submission, and ongoing management of clinical policies, drug lists, and benefit requirements. This role focuses on accurately translating approved clinical strategies into operational systems and tools, requiring strong attention to detail, independent problem solving, and consistent execution within established processes.The Clinical Policy Operations Professional 2 ensures accuracy and compliance for utilization...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Pharmacists
Career Level / Education:
Doctoral or professional degree
Salary:
N/A
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Strategic Project Manager - Medicaid Capture Management

Humana
Columbus, OH
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**Become a part of our caring community**The Medicaid Capture Management ...
Details
Summary
About the job:
team's purpose is to successfully position Humana to enter new markets enabling the future of the business. As a centrally positioned strategic function this team coordinates with growth partners across the enterprise and industry to accelerate product strategy and define the operating model for new markets. We deliver value through detailed research, data-driven insights, strategic planning, structured problem solving, and project management rigor.The Strategic Project Manager plays a central role in bringing structure,...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
N/A
From:
US.jobs
Certifications / Licenses:
Project Management Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Inbound Contact Representative 2

Humana
Columbus, OH
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**Become a part of our caring community**The Inbound Contacts Representative ...
Details
Summary
About the job:
2 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.The Inbound Contacts Representative 2 addresses customer needs which may include complex benefit questions, resolving issues, and educating providers. Records details of inquiries, comments or complaints, transactions or...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Strategic Project Manager - Medicaid Capture Management

Humana
Saint Paul, MN
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**Become a part of our caring community**The Medicaid Capture Management ...
Details
Summary
About the job:
team's purpose is to successfully position Humana to enter new markets enabling the future of the business. As a centrally positioned strategic function this team coordinates with growth partners across the enterprise and industry to accelerate product strategy and define the operating model for new markets. We deliver value through detailed research, data-driven insights, strategic planning, structured problem solving, and project management rigor.The Strategic Project Manager plays a central role in bringing structure,...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
N/A
From:
US.jobs
Certifications / Licenses:
Project Management Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Clinical Policy Operations Professional 2

Humana
Saint Paul, MN
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Save to My Profile
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**Become a part of our caring community**The Clinical Policy Operations ...
Details
Summary
About the job:
Professional 2 provides operational support to clinical pharmacists for the implementation, maintenance, submission, and ongoing management of clinical policies, drug lists, and benefit requirements. This role focuses on accurately translating approved clinical strategies into operational systems and tools, requiring strong attention to detail, independent problem solving, and consistent execution within established processes.The Clinical Policy Operations Professional 2 ensures accuracy and compliance for utilization...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Pharmacists
Career Level / Education:
Doctoral or professional degree
Salary:
N/A
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Inpatient Medical Coding Auditor

Humana
Saint Paul, MN
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**Become a part of our caring community**Are you a detail-driven coding ...
Details
Summary
About the job:
expert who enjoys solving complex clinical puzzles and making a measurable impact on payment accuracy and provider satisfaction?Humana, a Fortune 100 Company, is looking for an experienced, Remote medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Medical Records Specialists
Career Level / Education:
Postsecondary nondegree award
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
ICD-10 / ICD-9
Registered Health Information Administrator
Certified Coding Specialist
Registered Health Information Technician
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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