NewMedical Coding Auditor Humana IncMedical Coding AuditorRemote$59,300–$80,900 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments.
Medical Coding Auditor (Outpatient) HumanaMedical Coding Auditor (Outpatient)RemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
Nurse Case Manager II Apidel TechnologiesNurse Case Manager IIRemoteRemoteContractorThrough the use of clinical tools and information/data review, conducts comprehensive assessments of referred member\'s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member\'s benefit plan and available internal and external programs/services. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Director, Process Improvement Humana IncDirector, Process ImprovementRemote$150,000–$206,300 / yearYou will manage provider data business intelligence, including business case and value for supporting efficiency opportunities and ongoing processes improvements across manual and automated provider operations. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
NewAccount Manager - CarepathRx - Remote The Cigna GroupAccount Manager - CarepathRx - RemotePARemoteThese states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. In this role, you will build strong referral relationships, coordinate complex home-care services, and partner with clinical and operational teams to deliver seamless, cost-effective care and a positive patient experience.
Sr. Specialty Pharmacy Sales Executive Humana IncSr. Specialty Pharmacy Sales ExecutiveChicago, ILRemote$93,200–$157,100 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients.
NewSenior Manager, Financial Planning and Analysis Credit Acceptance CorporationSenior Manager, Financial Planning and AnalysisRemoteThe Senior Manager of Financial Planning & Analysis serves as a strategic finance partner to executive leaders and business owners, providing financial insight, budget management support, and decision-making guidance across operational areas. Challenge spending assumptions, business cases, and investment requests to ensure resources are aligned with strategic priorities, expected returns, affordability, and budget implications.
Scientist III - CMC Cardinal Health IncScientist III - CMCRemote$94,900–$135,600 / yearOperating in a client-facing, consultant capacity, this role provides strategic guidance on complex regulatory submissions, authors and reviews high-impact documentation, and drives alignment across cross-functional teams to ensure successful regulatory outcomes. Headquartered in Dublin, Ohio, Cardinal Health, Inc. (NYSE: CAH) is a global, integrated healthcare services and products company connecting patients, providers, payers, pharmacists and manufacturers for integrated care coordination and better patient management.
Patient Engagement Associate Penn MedicinePatient Engagement AssociatePhiladelphia, PARemoteSchedule patient appointments by determining reason for visit, following established schedules and protocols, using appropriate billing area/appointment location, communicating changes and confirming appointments, and as needed, offering alternative and canceling/rescheduling appointments. Responsibilities: Strives to understand and anticipate patient needs to improve the patient encounter and overall Penn Medicine experience, manages service recovery efforts when needed, enlisting management assistance as appropriate.
Escrow Supervisor- Remote LoanCareEscrow Supervisor- RemoteRemote$52,400–$88,000 / yearFull timeWe provide the necessary equipment; all you need is a quiet, private place in your home and a high-speed internet connection with a minimum network download speed of 25 megabits per second (MBPS) and a minimum network upload speed of 10 MBPS. Lifestyle & Learning Perks: Enjoy discounts on gym memberships, pet insurance, and employee purchasing programs, plus access to a tuition reimbursement program that supports your continued education and professional growth.
NewProvider Engagement Professional - Behavioral Health HumanaProvider Engagement Professional - Behavioral HealthOklahomaRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The Provider Relations Representative is responsible for day-to-day front line relationship management for network providers in Humana’s Healthy Horizons in Oklahoma’s Medicaid Plan, including provider onboarding, training, education, responding to provider inquiries, and resolving issues or complaints.
Medical Coding Auditor Evaluation & Management Humana IncMedical Coding Auditor Evaluation & ManagementRemote$59,300–$80,900 / yearWork At Home / Internet Information: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits.
Dr. Call Mail Operations Pharmacy Technician CenterWellDr. Call Mail Operations Pharmacy TechnicianArizonaRemoteAs the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Manager, Care Management HumanaManager, Care ManagementQuincy, IllinoisRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Onsite Care Coordination Nurse HumanaOnsite Care Coordination NurseMadison, WisconsinRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$71,100 - $97,800 per yearThis job is eligible for a bonus incentive plan.
Registered Nurse Care Manager- Fond du Lac HumanaRegistered Nurse Care Manager- Fond du LacFond Du Lac, WisconsinRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved.
Lead Decision Intelligence Engineer - NBA HumanaLead Decision Intelligence Engineer - NBARemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. This role is hands-on and research-oriented: you will implement and evaluate RL algorithms, instrument training pipelines, collaborate closely with data and platform engineers, and ensure the model operates correctly within the constraints of clinical eligibility rules and program-specific reward structures.
RN Care Manager HumanaRN Care ManagerMilwaukee, WisconsinRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved.
RN Care Manager- La Crosse/Sparta HumanaRN Care Manager- La Crosse/SpartaLa Crosse, WisconsinRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved.
NewRN Care Manager- Eau Claire Humana IncRN Care Manager- Eau ClaireEau Claire, WIRemote$71,100–$97,800 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved.