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Encounter Data Management Professional Encounter Data Management Professional

Humana
Located in Ohio
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Become a part of our caring community and help us put health first Encounter ...
Details
Summary
About the job:
Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area....
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Clinical Data Managers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Jobgether
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Detailed Job Information

Chief Medical Officer - Group Medicare

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:
Chief Medical Officer (CMO), Group Medicare leads and is accountable for the clinical performance of a $12B in revenue Group Medicare Segment and will serve as a key member of the Group Medicare Leadership Team, directly responsible for and overseeing multiple teams within Group Medicare. Will develop, articulate and advance the clinical vision and mission both within the organization and externally with Clints to drive outcomes and performance for the overall team.With deep clinical expertise, the CMO develops and...
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)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Chief Medical Officer - Group Medicare

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:
Chief Medical Officer (CMO), Group Medicare leads and is accountable for the clinical performance of a $12B in revenue Group Medicare Segment and will serve as a key member of the Group Medicare Leadership Team, directly responsible for and overseeing multiple teams within Group Medicare. Will develop, articulate and advance the clinical vision and mission both within the organization and externally with Clints to drive outcomes and performance for the overall team.With deep clinical expertise, the CMO develops and...
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)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medicaid Reconciliation Professional II

Humana
Saint Paul, MN
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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:
Medicaid Process Improvement Professional 2 is responsible for analyzing and evaluating the effectiveness of existing Medicaid business processes, with a focus on eligibility, enrollment, claims, and compliance workflows. This role develops sustainable, repeatable, and measurable improvements that align with Medicaid program requirements and regulatory standards.Assignments are varied and often require interpretation of Medicaid-specific policies and data. The role demands independent judgment to determine the most...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Manager, Telephonic RN

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:
Compact licensed telephonic Care Manager works from home in a call center environment.They assess and evaluate members' needs and requirements to achieve or maintain optimal wellness by providing care coordination and facilitating member or family interaction with resources appropriate for the care and wellbeing of the member.**Job Description**Humana Care Support is a division of Humana dedicated to helping adults remain independent in their homes. Our nurses are called Care Managers, because our case management...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
Certified Registered Nurse
Certified Case Manager
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medicaid Reconciliation Professional II

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:
Medicaid Process Improvement Professional 2 is responsible for analyzing and evaluating the effectiveness of existing Medicaid business processes, with a focus on eligibility, enrollment, claims, and compliance workflows. This role develops sustainable, repeatable, and measurable improvements that align with Medicaid program requirements and regulatory standards.Assignments are varied and often require interpretation of Medicaid-specific policies and data. The role demands independent judgment to determine the most...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Director, Pharmacy Revenue Cycle Management

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:
Director, Revenue Cycle Management for Humana Pharmacy will own the billing, collections and reporting for CenterWell Pharmacy & Specialty pharmacy and Humana Pharmacy Solutions, Humana's captive PBM.This role will lead a large workforce across multiple geographies to maximize our billing while also ensuring to meet our patient, pharmaceutical clients and PBM partner needs. Within CenterWell Pharmacy, we continue to lead the industry with new product launches, including our Direct to Consumer and Direct to Employer...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Associate Director, Technology Solution Implementation Associate Director, Technology Solution Implementation

Humana
Located in Ohio
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Become a part of our caring community and help us put health first The ...
Details
Summary
About the job:
Associate Director, Technology Solution Implementation delivers new technological solutions to meet business needs within a specified scope while aligned to enterprise objectives. The Associate Director, Technology Solution Implementation requires a solid understanding of how organization capabilities interrelate across department(s). The Associate Director, Technology Solution Implementation gathers and documents business system and functional requirements, influences system design to optimize support and ensures...
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:
Jobgether
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lead Product Manager - AI Solutions Lead Product Manager - AI Solutions

Humana
Located in Ohio
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Become a part of our caring community and help us put health first The ...
Details
Summary
About the job:
Enterprise AI organization at Humana is a pioneering force, driving AI innovation across our Insurance and CenterWell business segments. By collaborating with world-leading experts, we are at the forefront of delivering cutting-edge AI technologies for improving care quality and experience of millions of consumers. We are actively seeking top talent to join us in shaping the future of healthcare through AI excellence. We are seeking a dynamic and experienced Lead Product Manager to join our team (known internally as Lead,...
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:
Jobgether
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Business Systems Analysis Professional

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 Systems Analysis Professional 2 will support the Payment Integrity Electronic Medical Record (EMR) Team in the onboarding, implementation, and maintenance of new EMR vendor connections, with a primary focus on Cerner and Integrated Delivery Network (IDN) projects.This position will serve as the main point of contact for Cerner provider integrations scheduled to begin going live in 2026, ensuring successful recruitment, performance monitoring, troubleshooting, and product testing. The Business Systems Analysis...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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