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1 - 10 of 16 matches in 0.005 seconds
Pharmacy Special Investigations Professional (Fraud, Waste & (JC170629196)
Last Updated: 2020-10-19
Employer: Humana
Location: Dover, DE

Description

The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

Where you Come In

The Pharmacy Special Investigations Professional is…

Pharmacy Special Investigations Professional (Fraud, Waste & (JC170629599)
Last Updated: 2020-10-19
Employer: Humana
Location: Wilmington, DE

Description

The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

Where you Come In

The Pharmacy Special Investigations Professional is…

Lead Enterprise Architect-Thought Leader (virtual remote hom (JC170761193)
Last Updated: 2020-10-19
Employer: Humana
Location: Dover, DE

Description

The Lead Enterprise Architect translates business needs into systems solutions and architectural roadmaps. The Lead Enterprise Architect works on problems of diverse scope and complexity ranging from moderate to substantial and provides guidance to functional team(s). Skilled with broad, advanced technical experience especially in relation to enabling Platforms.

Responsibilities

Senior Cloud Architect- (Virtual Remote Home Office) (JC170427048)
Last Updated: 2020-10-19
Employer: Humana
Location: Dover, DE

Description

The Senior Cloud Architect leads the planning, design, and engineering of enterprise-level infrastructure and platforms related to cloud computing. The Senior Cloud Architect work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior Cloud…

Grievance and Appeals Representative 3 (JC170629327)
Last Updated: 2020-10-19
Employer: Humana
Location: Dover, DE

Description

The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request is warranted and then delivers final determination based on trained skillsets and/or partnerships with clinical and other Humana parties…

Pharmacy Business Optimization Lead (JC170761298)
Last Updated: 2020-10-19
Employer: Humana
Location: Dover, DE

Description

Humana Pharmacy Solutions is seeking a Pharmacy Business Optimization Lead. This individual will work with our various business channels and partners to optimize mail order pharmacy utilization by identifying programs and processes to help members access and maximize their pharmacy benefits. We are seeking a business savvy individual who…

Lead Actuary/Actuary- Senior Products-Part D (JC170371354)
Last Updated: 2020-10-19
Employer: Humana
Location: Dover, DE

Description

The Actuary, Pricing is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new plans and benefit changes. Provides guidance to Product Development on new product/benefit cost impacts. Develops and maintains pricing tools that…

Senior Provider Contracting Professional (JC170427029)
Last Updated: 2020-10-19
Employer: Humana
Location: Dover, DE

Description

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of…

Provider Relations Manager (eBusiness) (JC170761343)
Last Updated: 2020-10-19
Employer: Humana
Location: Dover, DE

Description

Be a part of the eBusiness team, drivers of provider self-service adoption through education and promotion of electronic transactions the Availity secure provider portal, Watson Voice, EDI, etc. As a Provider Relations Manager, you will collaborate cross-functionally with other business partners to improve the provider experience via the…

Lead Enterprise Architect-Thought Leader (virtual remote hom (JC170761351)
Last Updated: 2020-10-19
Employer: Humana
Location: Wilmington, DE

Description

The Lead Enterprise Architect translates business needs into systems solutions and architectural roadmaps. The Lead Enterprise Architect works on problems of diverse scope and complexity ranging from moderate to substantial and provides guidance to functional team(s). Skilled with broad, advanced technical experience especially in relation to enabling Platforms.

Responsibilities

Legend

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