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Risk Adjustment Coder

Humana
Columbus, OH
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**Become a part of our caring community**The Risk Adjustment Coder conducts ...
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Summary
About the job:
quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record.+ Reviews medical records to...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Information and Record Clerks, All Other
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
US.jobs
Certifications / Licenses:
Certified Professional Coder
Certified Inpatient Coder
Certified Customs Specialist
American Health Information Management Association
ICD-10 / ICD-9
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Detailed Job Information

Director, Behavioral Economics

Humana
Columbus, OH
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**Become a part of our caring community**The Director, Behavioral Economics ...
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Summary
About the job:
Nudge Unit is the expert leader and internal face of Humana's industry-leading Behavioral Economics team.The Director, Behavioral Economics Nudge Unit is the expert leader and internal face of Humana's industry-leading Behavioral Economics team. The Director brings expertise in applied behavioral science and causal inference, leading a team accountable for answering questions like:+ How can Humana use technological solutions to better support healthy member behaviors?+ What'sthe best way for Humana to respond when a...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Education Administrators, Postsecondary
Career Level / Education:
Master'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

UM Administration Coordinator

Humana
Columbus, OH
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**Become a part of our caring community**As a remote Utilization Management ...
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Summary
About the job:
(UM) Administrative Coordinator you will report to a Supervisor of Referrals and support the Behavioral Health (BH) UM department and perform varied activities with a focus on administrative and supportive assignments.+ You will monitor the BH UM phone queue+ You will enter data into medical management system+ You will provide non-clinical overview of documentation to pend tasks to appropriate queues who can complete or request additional information**Use your skills to make an impact****Required Qualifications**+ Our...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Correspondence Clerks
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
US.jobs
Certifications / Licenses:
Security clearance
ICD-10 / ICD-9
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Data Products & Strategy Lead

Humana
Columbus, OH
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**Become a part of our caring community**The Data Product & Strategy Lead ...
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Summary
About the job:
drives enterprise value by developing automation opportunities across CenterWell segments, including Home Health, Primary Care, and Pharmacy. You will partner with others to uncover workflow inefficiencies and design human-centered, AI-enabled solutions that improve experience, efficiency, use, and clinical/operational outcomes. Through data analysis and process mapping, you will define leading indicators to measure important CenterWell successes and guide continuous improvement. You will promote scalable, reusable...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Data Scientists
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

Subrogation Professional

Humana
Columbus, OH
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**Become a part of our caring community**The Subrogation Professional 2 ...
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Summary
About the job:
investigates accident, injury, and claim events to determine whether Humana may have the right to recover claim payments from another responsible party. This role gathers information from members, providers, insurance adjusters, attorneys, and other parties; reviews claim payments; creates liens; and negotiates repayment when appropriate. You will report to a Supervisor.+ Review new accident, injury, or claim events to determine whether subrogation or other party liability may apply+ Contact members, providers, insurance...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lead, Data Quality/Integrity - Clinical Abstraction Operations

Humana
Columbus, OH
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**Become a part of our caring community**Humana's Stars is an organization ...
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Summary
About the job:
that improves health outcomes and improves the care experience of our members and provider partners through quality solutions. Stars is committed to caring for our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). One key element of this quality rating is the operational execution and performance of the Healthcare Effectiveness Data and Information Set (HEDIS) measures.The Stars Team is seeking a Lead, Data Quality/Integrity for Clinical Abstraction Vendor...
Location:
Columbus, OH
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:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Formulary Operations Management Professional 2

Humana
Columbus, OH
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**Become a part of our caring community**The Formulary Operations Management ...
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Summary
About the job:
Professional 2 provides operational leadership for build, maintenance, submission, and updating of formularies and drug lists. The Formulary Operations Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Formulary Operations Management Professional 2 ensures accuracy of formularies and utilization management (UM) criteria in the Centralized Formulary System. Collaborates with healthcare professionals,...
Location:
Columbus, OH
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

Compliance Lead

Humana
Columbus, OH
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**Become a part of our caring community**The Compliance Lead ensures ...
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Summary
About the job:
compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial.The Compliance Lead serves as the dedicated Compliance Officer for Michigan to analyze business requirements, provide research and regulatory interpretation, and advise internal business units and external business partners in delivering results in a manner that minimizes compliance risk exposure for the Company. As a Compliance Lead for our Medicaid business, you will be part...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Compliance 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

Lead Digital Product Manager

Humana
Columbus, OH
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**Become a part of our caring community**A lead product manager manages ...
Details
Summary
About the job:
multiple simultaneous projects and oversees all aspects of each project, from conception to completion.Lead product managers may also task themselves with developing new products or features within existing offerings. This requires them to work with other departments -such as engineering, service, ops, sales, etc.-to ensure that they're building something that meets the needs of both the customer and the business.**Key Responsibilities****Product Strategy & Roadmap**+ Lead the product vision and roadmap for assigned...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Information Technology Project 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

Lead Digital Product Manager

Humana
Saint Paul, MN
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**Become a part of our caring community**A lead product manager manages ...
Details
Summary
About the job:
multiple simultaneous projects and oversees all aspects of each project, from conception to completion.Lead product managers may also task themselves with developing new products or features within existing offerings. This requires them to work with other departments -such as engineering, service, ops, sales, etc.-to ensure that they're building something that meets the needs of both the customer and the business.**Key Responsibilities****Product Strategy & Roadmap**+ Lead the product vision and roadmap for assigned...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Information Technology Project 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
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