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Results based on filters ( 2017 jobs found )

Senior Provider Analytics Professional

Humana
Saint Paul, MN
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**Become a part of our caring community**The Senior Provider Analytics ...
Details
Summary
About the job:
Professional leverages data and analytics, building impactful value models and BI solutions to deliver actionable insights that inform enterprise strategy. You will report to the Director, Provider Performance and Engagement Analytics.The Senior Provider Analytics Professional (Senior Value-Based Programs Professional) advises executives to develop functional strategies (often segment specific) on matters of significance through actionable insights and reporting. Key responsibilities include:+ Partners with Compass Value...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Business Intelligence 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

Grievances & Appeals Representative 2 - Medicaid

Humana
Columbus, OH
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**Become a part of our caring community**The Grievances & Appeals ...
Details
Summary
About the job:
Representative 2 triages Medicaid and AIP (dual) expedited cases and reviews clinical documentation to determine if a grievance or appeal is warranted. This is an extremely high-volume, fast-paced role, with the responsibility of moving several cases per hour. We ask that you have proactive queue management, attention to changing processes, experience handling support requests across multiple workstreams, and effective communication with managers and team leads.As a Grievances & Appeals Representative 2, you will:+ Review and...
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

Lead Cloud Security Architect WIAM

Humana
Columbus, OH
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**Become a part of our caring community**Summary(Candidate should be located ...
Details
Summary
About the job:
in one of the following Metro locations: Louisville KY, NYC Metro, Dallas Metro, Charlotte NC Metro, South Florida, Washington DC metro, Chicago, Boston, Atlanta, Nashville).The Lead Cloud Security Architect will drive both the architectural vision and hands-on engineering implementation for Workforce IAM, Cloud IAM, and fine--grained authorization capabilities. This role will design and build modern identity and access patterns across cloud and application environments, develop- and implement PBAC infrastructure and...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Information Security Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
Certified Information Systems Security Professional
Cisco Certified Security Professional
Certified Information Security Manager
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Formulary Operations Management Professional 2

Humana
Saint Paul, MN
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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 clinical and 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. Collaborate with healthcare...
Location:
Saint Paul, MN
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

Grievances & Appeals Representative 2 - Medicaid

Humana
Saint Paul, MN
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**Become a part of our caring community**The Grievances & Appeals ...
Details
Summary
About the job:
Representative 2 triages Medicaid and AIP (dual) expedited cases and reviews clinical documentation to determine if a grievance or appeal is warranted. This is an extremely high-volume, fast-paced role, with the responsibility of moving several cases per hour. We ask that you have proactive queue management, attention to changing processes, experience handling support requests across multiple workstreams, and effective communication with managers and team leads.As a Grievances & Appeals Representative 2, you will:+ Review and...
Location:
Saint Paul, MN
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

Actuarial Director - Medicaid Pricing

Humana
Columbus, OH
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**Become a part of our caring community**The Director, Actuarial of Medicaid ...
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Summary
About the job:
Pricing provides actuarial support across a broad range of actuarial and business needs for specific product lines. You will require an in-depth understanding of how organization capabilities interrelate across the function or segment.The Director, Actuarial of Medicaid Pricing will report to the Associate VP, Lead Medicaid Actuary.Key Responsibilities:1. Rate Advocacy+ Lead proactive rate advocacy efforts across assigned Medicaid markets+ Identify gaps between emerging experience vs. state rate assumptions+ Develop...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Actuaries
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
Fellow of the Society of Actuaries
Associate of the Society of Actuaries
Member of the American Academy of Actuaries
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Deputy Chief Medical Officer

Humana
Saint Paul, MN
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**Become a part of our caring community**The Deputy Chief Medical Officer is ...
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Summary
About the job:
responsible for driving positive physician engagement and experience within our organization. Incumbent will represent Humana externally, driving industry partnerships and thought leadership in value-based care (VBC). Additionally, the incumbent will provide operational leadership in critical areas, including leadership of the Physician Collaborative, Pharmacy and Therapeutics Committee, Public Health and Pandemic Committees, and will represent Humana on the AHIP CMO Committee and with other external partners. The...
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:
Accredited Management Accountant

Medical License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Provider Analytics Professional

Humana
Columbus, OH
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**Become a part of our caring community**The Senior Provider Analytics ...
Details
Summary
About the job:
Professional leverages data and analytics to drive PCP-focused performance and engagement insights. You will report to the Associate Director, PCP Provider Performance & Engagement Analytics.The Senior Provider Analytics Professional (Senior Value-Based Programs Professional) will support market and corporate leaders by providing data-driven insights regarding the performance of provider contracts and related processes. Candidates should be able to explore, analyze, and present insights from complex datasets. The Senior...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Business Intelligence 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

Inbound Contact Representative

Humana
Columbus, OH
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**Become a part of our caring community**Are you a transitioning military ...
Details
Summary
About the job:
service member or a military spouse looking for an internship that supports the goal to put health first?The DOW SkillBridge Internship and Military Spouse Fellowship Programs will provide you with key training to perform your internship. You will partner with your team to support members, projects, and meeting goals impacting business outcomes. The professionals you work with at Humana will depend on the type of internship you select. They may include healthcare professionals, HR, and IT, to name a few. The objective...
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:
Security clearance
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
Actions
Apply
Save to My Profile
See all jobs from this company
See who you know on LinkedIn
Report this job
**Become a part of our caring community**The Formulary Operations Management ...
Details
Summary
About the job:
Professional 2 provides clinical and 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. Collaborate with healthcare...
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
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