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Senior Telecomm/Voice Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Become a part of our caring community and help us put health first. Do you thrive on working on the cutting edge? Excited about working with innovators in the early stages of ideas, products, or platforms? Do you want to be...

Date Post 04/26/2024 - Apply Now - Save Job

Medicaid Compliance Business Intelligence Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana Healthy Horizons is seeking a Medicaid Compliance Business Intelligence Lead who describes the tools, technologies, applications, and practices used to collect, integrate, analyze, and present the Medicaid segment's...

Date Post 04/26/2024 - Apply Now - Save Job

Business Intelligence Associate Director
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Director, Business Intelligence will be responsible for leading the operational performance of Value-Based Specialist Programs within the Service Fund organization. Overseeing a team of highly specialized...

Date Post 04/26/2024 - Apply Now - Save Job

Senior Enterprise Architect (remote virtual)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Do you love using data and advanced technologies to create amazing customer experiences? If so, you might be the perfect fit for our Enterprise Architecture team. Our mission is to align business strategy with technology...

Date Post 04/26/2024 - Apply Now - Save Job

Claims Research & Resolution Representative 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that involve customer contact, investigation, and resolution of claims. The Claims Research & Resolution Representative 2 performs varied activities...

Date Post 04/26/2024 - Apply Now - Save Job

Lead Technology Leader - Site Reliability Engineering
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Technology Leadership Professional is responsible for all aspects of software or hardware product delivery and performance. The Lead Technology Leadership Professional works on problems of diverse scope and complexity...

Date Post 04/26/2024 - Apply Now - Save Job

RN, Utilization Management - Behavioral Health
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical...

Date Post 04/26/2024 - Apply Now - Save Job

BILINGUAL Claims Research & Resolution Representative 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages claims operations that involve customer contact, investigation, and resolution of claims. The Bilingual Claims Research & Resolution Representative 2 performs...

Date Post 04/26/2024 - Apply Now - Save Job

Utilization Management Strategy Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Clinical Strategy team is a multi-disciplinary team focused on creating data-driven strategies to transform our business and the experiences we create for our members, provider partners & associates. We partner closely with...

Date Post 04/26/2024 - Apply Now - Save Job

Medical Director - North Central Region - Medicaid
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director (Staff Geriatrician or Physician with Ten (10) Years of Clinical Practice with Older Adults) works assignments involve moderately...

Date Post 04/25/2024 - Apply Now - Save Job

Social Services (LMSW/LCSW) - Care Management Support
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and...

Date Post 04/25/2024 - Apply Now - Save Job

Business Intelligence Engineer - Group Benefits
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Business Intelligence Engineer 2 for Group Benefits solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Engineer 2 work...

Date Post 04/25/2024 - Apply Now - Save Job

RN - Nursing Educator 2 (UM, CM, Pre-Certs, Compliance) - Remote
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The RN, Nursing Educator 2 plans, directs, coordinates, evaluates, develops, delivers training and education programs for professional nursing personnel. The RN, Nursing Educator 2 work assignments are varied and frequently...

Date Post 04/25/2024 - Apply Now - Save Job

Program Delivery Professional 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Healthcare Quality Reporting & Improvement (HQRI) is an organization responsible for improving health outcomes and advancing the care experience of our members and provider partners through integrated risk adjustment (RA) and...

Date Post 04/25/2024 - Apply Now - Save Job

Senior Accreditation Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** We are seeking a Senior Accreditation Professional who will work in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple...

Date Post 04/25/2024 - Apply Now - Save Job

Data & Reporting Professional, SPARx
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Data and Reporting Professional 2 generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Data and Reporting Professional...

Date Post 04/25/2024 - Apply Now - Save Job

Utilization Behavioral Health Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services...

Date Post 04/25/2024 - Apply Now - Save Job

Medical Director - Northeast Region
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work...

Date Post 04/25/2024 - Apply Now - Save Job

Associate Director - Network Adequacy
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Director, Network Adequacy tests the overall network in each county of operations to ensure the network is strong enough to support serving customers. The Associate Director, Network Adequacy generates ad hoc...

Date Post 04/24/2024 - Apply Now - Save Job

Actuarial Analyst- Analytics/Forecasting
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data...

Date Post 04/24/2024 - Apply Now - Save Job

Sr. Value-Based Programs Professional (Remote US)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Sr. Value-Based Programs professional supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. This position will be responsible for leading...

Date Post 04/24/2024 - Apply Now - Save Job

Network Development MSO Sales Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Network Development MSO Sales Lead will develop and execute growth strategies for CenterWell's MSO (Management Services Organization)/IPA network. This role is responsible for engaging independent primary care practices on...

Date Post 04/24/2024 - Apply Now - Save Job

Business Intelligence Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Business Intelligence Engineer solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Engineer work assignments are varied...

Date Post 04/24/2024 - Apply Now - Save Job

Partner Sales Executive
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Partner Sales Executive develops and maintains relationships with small and medium-sized accounts. The Partner Sales Executive work assignments involve moderately complex to complex issues where the analysis of situations...

Date Post 04/24/2024 - Apply Now - Save Job

Actuary
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Actuary, MAPD Rx 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...

Date Post 04/24/2024 - Apply Now - Save Job

Pharmacy Claims Representative
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. **Essential Duties and Responsibilities:** * Assist in setting up and maintaining...

Date Post 04/24/2024 - Apply Now - Save Job

Senior Learning Design Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Learning Design Professional uses instructional design, cognitive psychology and adult learning theory to determine the appropriate solution to a knowledge or performance gap. The Senior Learning Design Professional...

Date Post 04/24/2024 - Apply Now - Save Job

Medical / Financial Risk Evaluation Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Medical/Financial Risk Evaluation Professional 2 is responsible for supporting the development, implementation and monitoring of medical/financial risk. The Medical/Financial Risk Evaluation Professional + Identifies,...

Date Post 04/24/2024 - Apply Now - Save Job

Accreditation Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Responsible for leading all NCQA Health Equity Accreditation work for Humana's Medicaid markets. The ideal candidate will have a proven track record of success in accreditation and survey administration, as well as experience...

Date Post 04/24/2024 - Apply Now - Save Job

Medicaid (PPS) Provider Hospital Reimbursement Methodologies Ana
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer Business and System Support team responsible for administering complex...

Date Post 04/24/2024 - Apply Now - Save Job

Senior Category Manager Enterprise Consulting, Procurement Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Consulting Category Leader is responsible for leading the sourcing and procurement of consulting services for the organization. The role involves developing and managing the consulting category strategy, executing sourcing...

Date Post 04/24/2024 - Apply Now - Save Job

Associate Actuary - Medicaid Trend
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data...

Date Post 04/24/2024 - Apply Now - Save Job

IT M&A Cybersecurity Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana is a Fortune 50 market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana starts from within, and...

Date Post 04/24/2024 - Apply Now - Save Job

UM Appeals Nurse 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse...

Date Post 04/22/2024 - Apply Now - Save Job

Enterprise Service Desk Lead - IT
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Are you looking for an opportunity to be an integral part of an IT Service Desk transformation? The ideal candidate will have at least 5 years' experience as an IT Service Desk Leader with experience managing and leading...

Date Post 04/20/2024 - Apply Now - Save Job

Lead Product Manager - Salesforce Health Cloud
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Product Manager Conceives of, develops, delivers, and manages products for customer use. The Lead Product Manager works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead...

Date Post 04/20/2024 - Apply Now - Save Job

National Account Executive
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Are you passionate about contributing to the well-being of the Medicare population? Would you like to play an integral and strategic part in the overall success of a team? If so, the National Account Executive is responsible...

Date Post 04/20/2024 - Apply Now - Save Job

Coding Educator
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 work assignments are varied and frequently require...

Date Post 04/20/2024 - Apply Now - Save Job

Integrated Health - Senior Business Intelligence Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Business Intelligence Engineer solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. This role will manage dashboarding of patient experience...

Date Post 04/20/2024 - Apply Now - Save Job

Integrated Health - Senior Informaticist
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Informaticist solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. This role will use advanced or predictive modeling to develop, test, and...

Date Post 04/20/2024 - Apply Now - Save Job

Director, Strategy Advancement
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Director, Enterprise Transformation directs and oversees a team of project management, process improvement, change management, and learning and design professionals supporting multiple high-priority projects. This role...

Date Post 04/20/2024 - Apply Now - Save Job

Senior Product Owner (SFMC)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Corporate Marketing organization is looking for a Senior Product Owner that is Salesforce Marketing Cloud Email Specialist certified to join the Marketing Regulatory and Operational Communications (MROC) team. If you...

Date Post 04/20/2024 - Apply Now - Save Job

Actuarial Analyst, Valuation
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Actuarial Analyst 2 will support financial reporting for the company's insurance businesses, primarily focused on claim reserves and other balance sheet liabilities. The Actuarial Analyst 2 will support financial reporting...

Date Post 04/20/2024 - Apply Now - Save Job

Lead Product Owner - Salesforce Health Cloud
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Lead Product Owner works on problems of diverse scope and...

Date Post 04/20/2024 - Apply Now - Save Job

Product Management Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Be a part of our Interoperability space - Humana is seeking Lead Product Managers to help accomplish enterprise interoperability goals that will lead to better information exchange, better outcomes and improved member...

Date Post 04/20/2024 - Apply Now - Save Job

Utilization Management Strategy Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Clinical Strategy team is a multi-disciplinary team focused on creating data-driven strategies to transform our business and the experiences we create for our members, provider partners & associates. We partner closely with...

Date Post 04/20/2024 - Apply Now - Save Job

Program Delivery Professional 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Healthcare Quality Reporting & Improvement (HQRI) is an organization responsible for improving health outcomes and advancing the care experience of our members and provider partners through integrated risk adjustment (RA) and...

Date Post 04/20/2024 - Apply Now - Save Job

Associate Director, SIEM & Detection Engineering(remote)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Director, SIEM & Detection Engineering oversees the SIEM engineering, alerting and detection strategy team for Humana systems. This role works closely with EIP's Threat Management and Response teams as well as...

Date Post 04/19/2024 - Apply Now - Save Job

Business Intelligence Lead - Medicaid
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The population health analytics team within Humana is dedicated to transforming health outcomes of Medicaid members using Humana's technology and analytics. We are looking for a Business Intelligence Lead who will design and...

Date Post 04/19/2024 - Apply Now - Save Job

Associate Director, Site Reliability Engineering - Automation Of
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** We're seeking a passionate experienced leader to lead our Automation team and play a key role in expanding our automation footprint across our organization. You'll be instrumental in driving our AIOps strategy by leveraging...

Date Post 04/19/2024 - Apply Now - Save Job

Associate Benefits Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Benefits Professional 2 will be integral to enhancing the company's position as a leader in health and well-being. In partnership with the Well-Being and Benefits team, the incumbent will create written and...

Date Post 04/19/2024 - Apply Now - Save Job

Medical Director - Southeast Region
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth...

Date Post 04/19/2024 - Apply Now - Save Job

SNP Support SS
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Social Services Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate...

Date Post 04/19/2024 - Apply Now - Save Job

Senior HR M&A Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior HR M&A Professional identifies, researches, analyzes, makes recommendations and negotiates certain criteria of potential mergers, acquisitions and divestitures to support the organization's growth objectives. The...

Date Post 04/19/2024 - Apply Now - Save Job

Lead DevSecOps Application Architect
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Are you interested in helping IT professionals reduce risk while making it easier for them to deliver the services our customers need, when they need it, to achieve their best health? In the Product Security team, our mission...

Date Post 04/19/2024 - Apply Now - Save Job

Strategy Advancement Advisor
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Come join our IT Strategy team! We design and activate strategies to address healthcare opportunities and challenges with technology-enabled solutions. As an Advisor in our team you'll enable Humana leaders as they leverage...

Date Post 04/19/2024 - Apply Now - Save Job

Referrals Coordinator
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Referrals Coordinator 2 processes referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer...

Date Post 04/19/2024 - Apply Now - Save Job

HEDIS Data and Reporting Lead, Medicaid Quality
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana is seeking a HEDIS Data and Reporting Lead to join the National Medicaid Quality team. The HEDIS Data and Reporting Lead reports to the National Medicaid Quality Director and oversees and coordinates all aspects of HEDIS...

Date Post 04/19/2024 - Apply Now - Save Job

Lead Proposal Writer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead, Content Development is a proposal writer who coordinates the development of Medicaid RFP content to effectively represent the products, services, brands, and/or the organization to customers. **The Lead, Content...

Date Post 04/19/2024 - Apply Now - Save Job