Become a part of our caring community and help us put health first Humana Healthy Horizons in Kentucky is seeking a Provider Engagement Professional to join the KY Medicaid Provider Relations team. In this role, you will develop and grow positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan. The P...
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 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Man...
Become a part of our caring community and help us put health first Humana Healthy Horizons in Virginia is looking for RN, Field Care Managers (Field Care Manager Nurse 2) who performs primarily face to face and telephonic assessments to adult and pediatric members. The RN, Field Care Manager (Field Care Manager Nurse 2) will evaluate member's needs to achieve and/or maintain optimal wellness. This position employs a variety of strategies, approac...
Become a part of our caring community and help us put health first The Manager, Consumer Service Operations is responsible for the daily activities for Florida Medicaid Contact Center Operations. The Manager, Consumer Service Operations works within specific guidelines to meet state contractual obligations for telephone performance and procedures. applies advanced technical knowledge to solve moderately complex problems. receives assignments in t...
Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care mana...
Become a part of our caring community and help us put health first Humana is currently seeking a part-time RN Case Manager to join our team, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career an...
Become a part of our caring community and help us put health first The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Coach 1 work assignments are often straightforward and of moderate complexity. We are looking for motivated and dynamic case...
Become a part of our caring community and help us put health first The Senior Automation Engineer designs, implements, and optimizes automation solutions that enhance efficiency, reliability, and decision-making across Engineering & Operations teams. driven insights. The Senior Automation Engineer designs, implements, and optimizes automation solutions that enhance efficiency, reliability, and decision-making across Engineering & Operations teams...
Become a part of our caring community and help us put health first The BH Care Coach (Crisis Service Care Coordinator) is a pivotal position serving members who access high-intensity services such as Mobile Crisis Response, Community Stabilization, 23-Hour Crisis Services, and Residential Crisis Service Units, or may have high emergency department (ED) utilization. This role is established to address the cycle of repeated utilization of costly cr...
Become a part of our caring community and help us put health first Humana Gold Plus Integrated is seeking Provider Engagement Professionals (LTSS) who are responsible for day-to-day, front-line relationship management for network providers in Humana. This role supports provider onboarding, training, education, and inquiry/issue support and resolution. The individuals in this role should have critical thinking/problem solving skills, an understand...
Become a part of our caring community and help us put health first Join our Dodge County WI team at Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. This position will provide services to members in Polk and Burnett Counties. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members t...
Become a part of our caring community and help us put health first The Oklahoma Medicaid Market CFO analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. The Director, Financial Planning & Analysis requires an in-depth understanding of how organization capabilities interrelate across the function or segment. This individual is responsible for the strategic ma...
