Your Search Results

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

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 04/18/2024 - Apply Now - Save Job

HR Solutions Partner; Primary Care Organization
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The HR Solutions Partner 2 supports the human resources function in the implementation and execution of effective human resource policies and practices which help the assigned client group achieve their business results. The HR...

Date Post 04/18/2024 - Apply Now - Save Job

Senior Software Engineer Varicent ICM
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Compensation Technology is responsible for the review, configuration, and testing of new internal sales commission plan requirements into our calculation engines. The Compensation is also responsible for the hand-off of the...

Date Post 04/18/2024 - Apply Now - Save Job

Medicaid RPA Analyst
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Data and Reporting Professional 2 (Medicaid RPA Analyst) generates automation flows and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Data...

Date Post 04/18/2024 - Apply Now - Save Job

Value Based Programs Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Value-Based Programs Lead 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 the...

Date Post 04/18/2024 - Apply Now - Save Job

Grievances & Appeals Representative
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The G&A rep 3 investigates and resolves grievances and appeals submitted by members and providers. Exercises discretion and judgement in prioritizing cases and interpreting procedures and processes. Works under limited guidance...

Date Post 04/18/2024 - Apply Now - Save Job

Cybersecurity Operations Engineer 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** In this position you will have the unique opportunity to support the Key and Certificate Lifecycle Management team; through innovative engineering you will contribute to improving our security posture through best of breed...

Date Post 04/18/2024 - Apply Now - Save Job

Senior Data and Reporting Professional
Humana - Carson City , NV

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

Date Post 04/18/2024 - Apply Now - Save Job

Senior Process Improvement Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Humana, we want to help people everywhere, including our associates, lead...

Date Post 04/18/2024 - Apply Now - Save Job

Research Scientist
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Clinical Analytics Team is seeking a Research Scientist (Remote). Our team identifies opportunities and builds solutions to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries...

Date Post 04/18/2024 - 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 04/18/2024 - Apply Now - Save Job

MarketPoint Reporting Director
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The MarketPoint Reporting Director leads a dynamic team of data and reporting professionals in the MarketPoint sales organization. This position requires an in-depth understanding of database structure, data visualization, and...

Date Post 04/18/2024 - Apply Now - Save Job

MarketPoint Implementation Director
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The MarketPoint Implementation Director gathers and documents business system and functional requirements, influences system design to optimize support and ensures solutions meet the business objectives and requirements....

Date Post 04/18/2024 - Apply Now - Save Job

Call Center and Claims Representative
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana/iCare is seeking a Call Center and Claims Representative to meet the needs of members, potential enrollees and providers by providing a resource by phone to answer inquiries related to benefits, eligibility, claims, and...

Date Post 04/18/2024 - Apply Now - Save Job

Senior Business Systems Analysis Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Business Systems Analysis Professional performs analysis of business, process and user needs, documentation of requirements, cost/benefit analysis and translation into proper system requirement specifications. The...

Date Post 04/18/2024 - Apply Now - Save Job

Medical Director - Florida
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 04/18/2024 - Apply Now - Save Job

Research Scientist
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Clinical Strategy and Analytics (CS&A) Team is seeking a Research Scientist 2 (Remote). Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions. The Clinical Strategy &...

Date Post 04/18/2024 - Apply Now - Save Job

Finance Process Professional - Acquisition Integration
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Finance Shared Services organization is looking for a Senior Finance Acquisition Integration Professional to drive project-oriented duties related to the finance integration of acquired entities into Humana. As the...

Date Post 04/18/2024 - Apply Now - Save Job

Senior Agile Coach
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Marketing organization is seeking an experienced Senior Agile Coach for our Agile Transformation initiative. The Senior Agile Coach will play a pivotal role in driving organizational change, fostering Agile mindset and...

Date Post 04/17/2024 - 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 04/17/2024 - Apply Now - Save Job

Lead Product Manager
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and providers, with full accountability from strategy to execution. **Location:** remote The Lead Product Manager partners...

Date Post 04/17/2024 - Apply Now - Save Job

Senior Proposal Development Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Proposal Development Professional assembles Request for Proposal (RFP)/Request for Information (RFI) responses into full proposal output. The Senior Proposal Development Professional assumes a hybrid Project...

Date Post 04/17/2024 - Apply Now - Save Job

Director, Systems Engineering
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Director, Solutions Engineering is responsible for leading the strategic direction, design, and implementation of associate technology at Humana, focused on computing and mobility solutions. This role will require a deep...

Date Post 04/17/2024 - Apply Now - Save Job

Market Consultation/Partnership Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The HQRI Provider Support Team (PST) Market Consultation/Partnership Professional 2 creates content and deploys training to provider facing associates on our market teams. The Market Consultation/Partnership Professional 2 work...

Date Post 04/17/2024 - Apply Now - Save Job

Lead Software Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Do you want be part of a team that is continuously learning and evolving to build modernized and innovative solutions? Do you want to transform an industry? Crave new challenges and solving hard customer problems using the...

Date Post 04/17/2024 - Apply Now - Save Job

Small Group Sales Representative
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Small Group Sales Representative works with agents and consultants to sell Ancillary Group insurance products to new and existing accounts with 2 - 50 eligible employees. The **Small Group Sales Representative** is...

Date Post 04/17/2024 - Apply Now - Save Job

Strategy Advancement Advisor
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Strategy Advancement Advisor plays a crucial leadership role that provides data-driven strategic guidance to deliver a consistent and best-in-class Provider Engagement function. The Strategy Advancement Advisor enhances...

Date Post 04/17/2024 - Apply Now - Save Job

Lead Technology Leadership Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** We are looking for an experienced, forward-thinking individual who can showcase skills managing highly-visible production impacting outages and navigating the needs of our business partners. We need someone who is...

Date Post 04/16/2024 - Apply Now - Save Job

Telephonic Nurse Case Manager
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The **Telephonic Nurse Case Manager** will be a member of the Case Management Team, providing a comprehensive, holistic approach for case management throughout the continuum of care. The case manager will offer guidance....

Date Post 04/16/2024 - Apply Now - Save Job

Designer 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Hive, Humana's in-house agency is seeking a Creative Development Professional, Designer 2 to join their team! We are a creative collective built exclusively to support the business and the brand. Our sole purpose is to...

Date Post 04/16/2024 - Apply Now - Save Job

Senior Product Manager
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** At Humana, we look for people who have a commitment to support the best health of our members and communities. We do this by delivering personalized, simplified, whole-person healthcare experiences. We value diversity and...

Date Post 04/14/2024 - Apply Now - Save Job

Senior Product Owner
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** At Humana, we look for people who have a commitment to support the best health of our members and communities. We do this by delivering personalized, simplified, whole-person healthcare experiences. We value diversity and...

Date Post 04/14/2024 - Apply Now - Save Job

Lead Product Manager
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 04/14/2024 - Apply Now - Save Job

Senior Cloud Automation Architect
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** At Humana, we are deeply focused on helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for...

Date Post 04/14/2024 - Apply Now - Save Job

IT Cloud Procurement Category Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Sr. Manager, Lead Category Manager will report directly into the Director of IT Procurement and will lead the development of category strategies, design sourcing plans, oversee negotiations, implement contracts, and drive...

Date Post 04/14/2024 - Apply Now - Save Job

Lead Product Manager
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Product Manager partners across various multi-disciplinary teams at Humana to design, define and deliver digital and non-digital clinical solutions to help drive improved health outcomes for our members. The Lead...

Date Post 04/14/2024 - Apply Now - Save Job

Senior Marketing Campaign Developer (AEP)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** In the fast-paced, ever-growing world of healthcare, Humana relies on the latest technology and trends for sharing and storing information, communication, and security. The Marketing, Regulatory and Operational Communications...

Date Post 04/14/2024 - Apply Now - Save Job

Inbound Contacts Beneficiary Service Rep (TRICARE Plans)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** If you are a problem solver, resourceful, and looking to make a difference for your family as well as others, we want you on the Humana Government Business team! Help us deliver exceptional experiences to our TRICARE members as...

Date Post 04/14/2024 - Apply Now - Save Job

Vendor Management Lead - Clinical Operations
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** In today's complex business environment, the role of a Vendor Management Lead is of utmost importance. This role oversees relationships between a company and its suppliers and ensures that all vendor-related activities align...

Date Post 04/13/2024 - Apply Now - Save Job

Lead, Stars Member Engagement Strategy
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Health Quality and Stars team is seeking a Program Delivery Lead to drive advancement of innovation opportunities focused on member engagement to both optimize health outcomes for our members and sustain industry leading...

Date Post 04/13/2024 - Apply Now - Save Job

Encounter Data Management Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all...

Date Post 04/12/2024 - Apply Now - Save Job

Senior Network Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Job Description Summary The Senior Network Engineer is responsible for the planning, design, and engineering of enterprise-level infrastructure and platforms related to networking. This role also provides strategic advice and...

Date Post 04/12/2024 - Apply Now - Save Job

Technology Implementations Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Technology Implementation Lead delivers new technological solutions to meet business needs within a specified scope while aligned to enterprise objectives. The Technology Implementation Lead works on problems of diverse...

Date Post 04/12/2024 - Apply Now - Save Job

Medicare Grievances and Appeals Corporate Medical Director
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to...

Date Post 04/12/2024 - Apply Now - Save Job

Senior Software Engineer - Mainframe
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Software Engineer codes software applications based on business requirements. The Senior Software Engineer work assignments involve moderately complex to complex issues where the analysis of situations or data...

Date Post 04/12/2024 - Apply Now - Save Job

Bilingual Translator-Proofreader (Spanish/English)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Marketing and Communications organizations is seeking a detail-oriented Bilingual Translator-Proofreader that is proficient in Spanish and English to join as a Production Professional 2 on the Translation Team. In this...

Date Post 04/12/2024 - Apply Now - Save Job

Senior Strategy Advancement Professional - Voice & Conversationa
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Strategy Advancement Professional will join the Experience Transformation Voice & Conversational Product Team and will provide technical, program and project management support to help manage the overall Consumer...

Date Post 04/12/2024 - Apply Now - Save Job

Senior Data Scientist
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Growth Analytics & AI within Humana is dedicated to transforming members' journeys and Humana's services using technology and analytics. We are looking for a Senior Data Scientist who will design studies and utilize...

Date Post 04/12/2024 - Apply Now - Save Job

Senior Risk Adjustment Administration Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Risk Adjustment Administration Professional will work closely with providers to identify documentation and coding improvement opportunities and give guidance around operational and clinical best practices in the risk...

Date Post 04/12/2024 - Apply Now - Save Job

Lead Software Engineer - Mainframe
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Software Engineer codes software applications based on business requirements. The Lead Software Engineer works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Software...

Date Post 04/12/2024 - Apply Now - Save Job

Associate Director, Medicaid Value Based Payment Solutions
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Director, Value-Based Solutions will be responsible for leading the operational performance of Humana Healthy Horizon's specialty value-based payment (VBP) model portfolio. The Associate Director will oversee a...

Date Post 04/12/2024 - Apply Now - Save Job

Associate Director, Engineering and Automation
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Director of Engineering and Automation is a focal role within our organization. Success in this role hinges on the individual's ability to lead, define, and implement a comprehensive quality engineering strategy...

Date Post 04/12/2024 - 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 04/12/2024 - 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 04/12/2024 - Apply Now - Save Job

Director, Strategy Advancement
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** At Humana, we are leading the industry in payer-to-provider interoperability and driving better outcomes for our providers and members. In this role, you will be directing the interoperability performance management function....

Date Post 04/12/2024 - 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 04/12/2024 - Apply Now - Save Job

Medical Director - Mid West 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, level of care, and/or site of service should be authorized. All work occurs within a...

Date Post 04/12/2024 - Apply Now - Save Job

Financial Analytics Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work...

Date Post 04/12/2024 - Apply Now - Save Job

Value Based Program - Data & Reporting Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Value Based Programs Lead generates ad hoc reports and regular datasets and/or report information for end-users using queries and scripts to inform value-based payment (VBP) model design and administration. The Data and...

Date Post 04/12/2024 - Apply Now - Save Job

Senior Product Owner - Digital Benefits Experience
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Product Owner, Digital Benefits Experience, will contribute to digital transformation and innovation of data products to present, transform, and distribute Medicare and Medicaid product data to better serve our...

Date Post 04/12/2024 - Apply Now - Save Job

Data Manager Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana Healthy Horizons is seeking a Data Manager Lead who supports all clinical and population health analysis and measurement in support of Medicaid's Equitable Population Health Management goals. The Data Manager Lead...

Date Post 04/12/2024 - Apply Now - Save Job

Workforce Management Analyst
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Workforce Management Analyst applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and...

Date Post 04/11/2024 - Apply Now - Save Job

Financial Analytics Lead - HQRI Finance
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Financial Analytics Lead manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Lead works on problems of diverse scope...

Date Post 04/11/2024 - Apply Now - Save Job

Associate VP, Customer Success Team
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate VP, Customer Success is responsible for member retention through active engagement with high-risk members. The Associate VP, Customer Success requires an in-depth understanding of how organization capabilities...

Date Post 04/10/2024 - Apply Now - Save Job

Director, Transformation
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana is a $100 billion (Fortune 42) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve....

Date Post 04/10/2024 - Apply Now - Save Job

Lead Product Owner
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Digital 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 Digital Product Owner will work directly with...

Date Post 04/10/2024 - Apply Now - Save Job

Senior Accreditation Utilization Management 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 04/10/2024 - Apply Now - Save Job

Learning Education Lead: Referrals & HIMS
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Learning Experience Education Lead is embedded in the PCO learning team as part of the learning experience function. The learning experience function is broadly responsible for all learning analytics, learning system (LMS)...

Date Post 04/10/2024 - Apply Now - Save Job

Senior Data and Reporting Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana Healthy Horizons is in search of a Senior Data and Reporting Professional who can contribute towards shaping the strategy for Florida's Long-term Care, with a focus on constructing a robust plan ready for expansion. This...

Date Post 04/10/2024 - Apply Now - Save Job

Editor-Proofreader
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Provider Communications team is seeking a detail-oriented Editor-Proofreader to join as a Production Professional 2 supporting the Medicaid line of business. Our goal is to effectively represent Humana in a respectful...

Date Post 04/10/2024 - Apply Now - Save Job

Senior Finance Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Financial Planning and Analysis Professional analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. The Senior Financial...

Date Post 04/09/2024 - Apply Now - Save Job

Associate Director- Business Systems Manager
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Director, Business Systems Analysis performs analysis of business, process and user needs, documentation of requirements, cost/benefit analysis and translation into proper system requirement specifications. The...

Date Post 04/09/2024 - Apply Now - Save Job

Senior Business Intelligence Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana is seeking a Senior Business Intelligence (BI) Engineer to join our Fortune #40, Best Places to Work company and help us make a difference as we help our members achieve their best health! The Senior Business...

Date Post 04/09/2024 - Apply Now - Save Job

Behavioral Health Medical Director - N. Central Medicaid
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new delivery models. Maintains efficient operations while ensuring attainment of quality of care and financial goals. Provides...

Date Post 04/09/2024 - Apply Now - Save Job

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

**Become a part of our caring community and help us put health first** The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work assignments involve moderately...

Date Post 04/09/2024 - Apply Now - Save Job

Medical Director- South Central
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 04/09/2024 - Apply Now - Save Job

Utilization Management 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 04/09/2024 - Apply Now - Save Job

Medical Director- South Central
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 04/06/2024 - Apply Now - Save Job

Pharmaceutical Manufacturer Relations Executive
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Pharmaceutical Manufacturer Relations Executive ensures the Pharmacy trade strategy aligns with formularies and the desired health outcomes of patients. The Pharmaceutical Manufacturer Relations Executive works on problems...

Date Post 04/06/2024 - Apply Now - Save Job

Network Operations Coordinator
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Job Description Summary The Network Operations Coordinator 4 maintains provider data to support customer service activities through data integrity management and gathering of provider data needed for service operations. The...

Date Post 04/06/2024 - Apply Now - Save Job

DVACO Quality Improvement Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Delaware Valley ACO (DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP). DVACO is a joint venture among three stakeholders:...

Date Post 04/06/2024 - Apply Now - Save Job

Lead SDLC Process Owner
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 the Systems Development Life Cycle (SDLC) for Humana IT. We're looking for a professional with experience designing or supporting an enterprise-wide...

Date Post 04/06/2024 - Apply Now - Save Job

Network Operations Coordinator
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Network Operations Coordinator 4 maintains provider data to support customer service activities through data integrity management and gathering of provider data needed for service operations. The Network Operations...

Date Post 04/06/2024 - Apply Now - Save Job

Senior Business Intelligence Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana Healthy Horizons is seeking a Senior Business Intelligence Engineer to join our National Medicaid Operations team. The Senior Business Intelligence Engineer solves complex business problems and issues using data from...

Date Post 04/06/2024 - Apply Now - Save Job

Medical Director - Florida
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 04/06/2024 - Apply Now - Save Job

Senior Product Owner
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana is rapidly evolving from an insurance company with elements of health to a healthcare company with elements of insurance. We are embarking on an ambitious journey to implement a new Member Administration Platform and...

Date Post 04/06/2024 - Apply Now - Save Job

Medical Director - Central 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 04/06/2024 - Apply Now - Save Job

Senior Project Manager (Medicaid Network Implementation)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana Healthy Horizons is a seeking a Senior Project Manager (Medicaid Network Implementation) who is accountable for working with the Director, Network Implementations, Provider Strategy & Operations, to assist with driving...

Date Post 04/06/2024 - Apply Now - Save Job

UM Administration Coordinator
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The UM Administration Coordinator 2 provides clerical support for the department. We are the beginning, middle and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses and...

Date Post 04/06/2024 - Apply Now - Save Job

Director, IT Procurement
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana seeks a dynamic Procurement Director, IT Professional Services, and Government Business to collaborate with c-suite executives, driving business transformation. This role requires leadership experience in diverse...

Date Post 04/05/2024 - Apply Now - Save Job

Data Scientist 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana is seeking a skilled and motivated Data Scientist to join our Distribution Analytics team. The MarketPoint Distribution Analytics team is a part of Humana's MarketPoint Organization, supporting the distribution of...

Date Post 04/05/2024 - Apply Now - Save Job

Director, Transformation
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana is a $100 billion (Fortune 42) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve....

Date Post 04/05/2024 - Apply Now - Save Job

Senior Business Technical Support Professional
Humana - Las Vegas , NV

**Become a part of our caring community and help us put health first** The Senior Business Technical Support Professional provides support for handling and analyzing data that pertains to the compliance and commissions of Humana external producers. The Senior Business Technical Support...

Date Post 04/05/2024 - Apply Now - Save Job

Lead Product Manager - Group Products- Life and Disability
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Product Manager Leads all phases of the product life cycle for group disability and life products, from inception to introduction into the marketplace. The position focuses on meeting specialty growth goals by...

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

Senior Application Architect
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Application Architect in Site Reliability Engineering (SRE) reviews designs and IT applications architecture solutions to business problems in alignment with the enterprise architecture direction and standards. The...

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

Lead Enterprise Architect
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Are you interested in leveraging technology and business strategy to deliver improved member experiences and health outcomes to Humana's 26 million members? Are you customer obsessed with a business-centric outlook? At the...

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

Bilingual Billing & Reconciliation Representative
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Bilingual Billing & Reconciliation Representative 3 determines discrepancies between company records and the records of Center for Medicare and Medicaid Services. The Bilingual Billing & Reconciliation Representative 3...

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

Lead Application Architect
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Application Architect in the Site Reliability Engineering organization works with multiple IT development, production support, platforms, and infrastructure teams to ensure the design, performance, and continuous...

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

Senior Risk Adjustment Administration Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Risk Adjustment Administration Professional will work closely with providers to identify documentation and coding improvement opportunities and give guidance around operational and clinical best practices in the risk...

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

Actuary
Humana - Carson City , NV

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

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

Technology Implementations Lead
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Technology Implementation Lead delivers new technological solutions to meet business needs within a specified scope while aligned to enterprise objectives. The Technology Implementation Lead works on problems of diverse...

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

Utilization Management 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 04/04/2024 - Apply Now - Save Job

Principal, Healthcare Strategy
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana, a Fortune 50 Healthcare Company Humana is a publicly traded, Fortune 50 healthcare company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home...

Date Post 04/03/2024 - Apply Now - Save Job

Legal Assistant/Billing Specialist
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** We are seeking a highly organized Legal Assistant who will be responsible for a variety of law-related tasks such as research, drafting legal documents and other related duties and manage our billing process. As a specialist in...

Date Post 04/03/2024 - Apply Now - Save Job

Supervisor - Utilization Management Pharmacy
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Supervisor, Utilization Management Pharmacy is a clinical pharmacist who leads a team of pharmacists who perform medical necessity reviews for prescriptions requiring pre-authorization. The Supervisor, Utilization...

Date Post 04/03/2024 - Apply Now - Save Job

Associate Director- Business Systems Manager
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate Director, Business Systems Analysis performs analysis of business, process and user needs, documentation of requirements, cost/benefit analysis and translation into proper system requirement specifications. The...

Date Post 04/03/2024 - Apply Now - Save Job

Director, IT Vendor Management
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Director, IT Vendor Management is responsible for the resource operating model strategy, third-party resource engagements, contract outcomes and related labor skillsets that enable the Site Reliability to support, maintain,...

Date Post 04/03/2024 - Apply Now - Save Job

Senior Technology Leadership Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Technology Leadership Professional is responsible for all aspects of software or hardware product delivery and performance. The Senior Technology Leadership Professional work assignments involve moderately complex to...

Date Post 04/03/2024 - Apply Now - Save Job

Principal Enterprise Architect
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Principal Enterprise Architect leads the planning, design, and engineering of enterprise-level application and solution architectures to leverage infrastructure and platforms related to cloud computing. The Principal...

Date Post 04/03/2024 - Apply Now - Save Job

Grievances & Appeals Representative
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Grievances & Appeals Representative 4 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...

Date Post 04/03/2024 - Apply Now - Save Job

UM Administrative Coordinator 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The UM (Utilization Management) Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex...

Date Post 04/03/2024 - Apply Now - Save Job

Senior Provider Education Strategy Advancement Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Provider Education Strategy Advancement Professional will work on a newly formed team responsible for planning and program ownership of the developing provider risk adjustment (RA) education strategy. If you like...

Date Post 04/02/2024 - Apply Now - Save Job

Learning Facilitation Professional 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Are you someone who is passionate about helping Sales Agents learn through facilitation and development? Then we have a job for you! Humana is in search for our next Learning Facilitation Professional 2 who will use adult...

Date Post 04/02/2024 - Apply Now - Save Job

Senior IT Software Vendor Management Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior IT Vendor Management Professional holds Humana's technology partners accountable via performance management, contract compliance, and relationship management, thereby allowing internal partners to focus on providing...

Date Post 04/02/2024 - Apply Now - Save Job

Medical Director- South Central
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 04/02/2024 - Apply Now - Save Job

Senior Full Stack Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Full Stack Engineer Performs software engineering activities in all layers of the stack, from setting up the database to programming in the back-end and the appearance at the front-end. The Senior Full Stack Engineer...

Date Post 04/02/2024 - Apply Now - Save Job

Humana Healthcare Research Summer Intern
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Through the design and implementation of various types of research studies and the strategic interpretation of data, the mission of Humana Healthcare Research (HHR) is to produce high-quality, actionable evidence and rigorous,...

Date Post 04/02/2024 - Apply Now - Save Job

Compensation Principal
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Compensation Principal develops, implements, and administers compensation programs. The Compensation Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical...

Date Post 04/02/2024 - Apply Now - Save Job

Marketing Strategy Lead, Group Medicare
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Group Medicare Marketing team is looking for an experienced and passionate Product Marketing Lead who is hyper customer focused with an ability to understand complex business models and develop marketing strategies...

Date Post 04/02/2024 - Apply Now - Save Job

Medical Director - National Medicare Team
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 preauthorization requests for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data...

Date Post 04/02/2024 - Apply Now - Save Job

Medical Director - National Medicare Team
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 preauthorization requests for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data...

Date Post 03/30/2024 - Apply Now - Save Job

Associate VP, Customer Success Team
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Associate VP, Customer Success is responsible for member retention through active engagement with high-risk members. The Associate VP, Customer Success requires an in-depth understanding of how organization capabilities...

Date Post 03/30/2024 - Apply Now - Save Job

Lead, IT Disaster Recovery
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead, IT Disaster Recovery role is focused on managing several key aspects of the disaster recovery program including process governance, program documentation, data management and evolving the DR management system....

Date Post 03/30/2024 - Apply Now - Save Job

Senior IAM Security Architect
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** We are seeking a highly skilled and experienced Senior IAM (Identity and Access Management) Architect with a strong background in Privileged Access Management. The successful candidate will play a crucial role in the overall...

Date Post 03/30/2024 - 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 03/30/2024 - Apply Now - Save Job

Humana Healthcare Research Summer Intern
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Through the design and implementation of various types of research studies and the strategic interpretation of data, the mission of Humana Healthcare Research (HHR) is to produce high-quality, actionable evidence and rigorous,...

Date Post 03/30/2024 - Apply Now - Save Job

Senior Product Owner
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Senior Product Owner work assignments involve moderately...

Date Post 03/30/2024 - Apply Now - Save Job

Director, Care Management
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Director, Care Management requires an in-depth understanding of how organization capabilities...

Date Post 03/30/2024 - Apply Now - Save Job

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. The Senior Business Intelligence Engineer work...

Date Post 03/30/2024 - Apply Now - Save Job

Senior IT Software Vendor Management Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior IT Vendor Management Professional holds Humana's technology partners accountable via performance management, contract compliance, and relationship management, thereby allowing internal partners to focus on providing...

Date Post 03/29/2024 - Apply Now - Save Job

Senior DSNP Encounter Submissions Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all...

Date Post 03/29/2024 - Apply Now - Save Job

Senior Financial Planning and Analysis Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana's Home Solutions Value-Based Organization is an integrated homecare service provider focused on meeting the needs of Health Plans by serving its members through a single source solution. We engage in risk-based (e.g.,...

Date Post 03/29/2024 - Apply Now - Save Job

Encounter Data Management Senior Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all...

Date Post 03/29/2024 - Apply Now - Save Job

Encounter Data Management Professional 2
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Encounter Data Management Professional 2 develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all...

Date Post 03/29/2024 - Apply Now - Save Job

Senior Network Engineer
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Network Engineer designs, analyzes, plans and modifies network components supporting customer communication implementation activities. The Senior Network Engineer work assignments involve moderately complex to...

Date Post 03/29/2024 - Apply Now - Save Job

Senior Consumer Experience Professional
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Senior Consumer Experience Professional ensures optimized interaction between a company and members. The Senior Consumer Experience Professional work assignments involve moderately complex to complex issues where the...

Date Post 03/29/2024 - Apply Now - Save Job

Graduate Analytics Internship
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** As an Analytics Intern, you will collect and analyze data related to various clinical populations, assessing clinical quality, health outcomes, quality of life, and cost. Your work will support Humana's strategic and tactical...

Date Post 03/28/2024 - 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 03/28/2024 - Apply Now - Save Job

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. The Senior Business Intelligence Engineer work...

Date Post 03/28/2024 - Apply Now - Save Job

Lead Product Owner
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** The Lead Digital 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 Digital Product Owner will work directly with...

Date Post 03/28/2024 - Apply Now - Save Job

Senior Project Manager (Medicaid Network Implementation)
Humana - Carson City , NV

**Become a part of our caring community and help us put health first** Humana Healthy Horizons is a seeking a Senior Project Manager (Medicaid Network Implementation) who is accountable for working with the Director, Network Implementations, Provider Strategy & Operations, to assist with driving...

Date Post 03/28/2024 - Apply Now - Save Job