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1 - 10 of 13 matches in 0.006 seconds
Senior Provider Contracting Professional (JC170426970)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

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

Pharmacy Special Investigations Professional (Fraud, Waste & (JC170629262)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

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

Responsibilities

Where you Come In

The Pharmacy Special Investigations Professional is…

Grievance and Appeals Representative 3 (JC170629513)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

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

Director, Insurance Product Management- Group Medicare (JC170629373)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

The Director, Insurance Product Management, manages the Group Medicare product portfolio. The Director, Insurance Product Management, requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

Responsibilities

The Director, Insurance Product Management – Group Medicare, leads design efforts for Group Medicare

+ Works in conjunction…

Policy Management Professional 2 (JC170629208)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

The Enterprise Policy Management Professional 2 contributes to the success of Humana’s business strategy by assisting in the creation, communication and governance of enterprise policies, standards and procedures. Part of the Enterprise Policy Management Professional 2’s role is to gather resources and data in order to provide business areas…

Senior Cloud Architect- (Virtual Remote Home Office) (JC170426849)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

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

Responsibilities

The Senior Cloud…

Workforce Management Professional 2 (JC170551244)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

The Workforce Management Professional 2 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 development, talent management, diversity and human resource compliance). The Workforce Management Professional 2 work assignments are varied and frequently require…

Senior Project Manager (JC170371245)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

The Senior PM manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Senior PM drives assignments that involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Lead Actuary/Actuary- Senior Products-Part D (JC170371332)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

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

Provider Contracting Executive (JC170427072)
Last Updated: 2020-10-19
Employer: Humana
Location: Portland, ME

Description

The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Provider Contracting Executive communicates contract terms, payment…

Legend

  • Registered Apprenticeship