• Medical Management Nurse

    Elevance Health (Atlanta, GA)
    …onboarding and skill development. Please note that per our policy on hybrid /virtual work, candidates not within a reasonable commuting distance from the posting ... that require nursing judgment, critical thinking, and holistic assessment of member 's clinical presentation to determine whether to approve requested service(s) as… more
    Elevance Health (11/18/25)
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  • Lead Enterprise Architect - EA Practices

    Humana (Atlanta, GA)
    …Systems **Why Humana?** Work-life harmony is not just a phrase here-it's a practice! Hybrid and remote work are considered normal. Near an office? No problem - stop ... rated by our associates. **Additional Information** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service… more
    Humana (11/21/25)
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  • Follow-up Senior Program Delivery Professional…

    Humana (Atlanta, GA)
    …ranging from moderate to substantial. **Location:** remote or strong preference for hybrid in Waterside Louisville, KY office The IHWA Follow-up Senior Program ... care environment/managed care **Additional Information** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet… more
    Humana (11/20/25)
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  • Senior Enterprise Transformation Professional…

    Humana (Atlanta, GA)
    …+ Build trusting relationships with business areas and leadership to improve member and provider experiences. + Provide leadership and guidance to engagement teams ... project activities. + Travel may be once a quarter for a week however dictated based on business needs **Use your skills to make an impact** **Role Essentials** +… more
    Humana (11/21/25)
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  • Grievances & Appeals Representative

    Humana (Atlanta, GA)
    …appeal or further request is warranted and then delivers final determination based on trained skillsets and/or partnerships with clinical and other Humana parties. ... or face to face, further/support quality related goals. Investigates and resolves member and practitioner issues. Decisions are typically focus on methods, tactics… more
    Humana (11/21/25)
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  • Associate Director, HEDIS Operations…

    Humana (Atlanta, GA)
    …and presentation of data to identify trends and opportunities for improved member health and measure compliance + Internal and external partnerships to coordinate, ... or a related field **Additional Information** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service… more
    Humana (11/21/25)
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  • BILINGUAL Claims Research & Resolution Rep 2

    Humana (Atlanta, GA)
    …hours of 8:00 AM to 6:00 PM Eastern. + Overtime _may_ be offered, based on business needs. **Preferred Qualifications** + Bachelor's Degree + Prior claims processing ... Proficiency Testing** Any Humana associate who speaks with a member in a language other than English must take...Government. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided… more
    Humana (11/21/25)
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  • Accreditation Professional

    Humana (Atlanta, GA)
    …building newsletters and taking meeting minutes. + Assist in document review of member handbooks and provider manuals to ensure NCQA compliance. + Support leadership ... a year) **Work-at-Home (WAH) Internet Statement** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service… more
    Humana (11/20/25)
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  • Principal Service Designer

    Humana (Atlanta, GA)
    …Define and drive service design strategy across enterprise initiatives, connecting member needs to operational capabilities. + **Systems Thinking:** Create service ... leadership and measurable impact **Work-At-Home Information** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet… more
    Humana (11/20/25)
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  • Senior Business Intelligence Engineer

    Humana (Atlanta, GA)
    …organization focused on eliminating health disparities and improving the member /patient experience **Preferred Qualifications** + Bachelor's degree + Advanced Degree ... your schedule. **Work at Home/Remote Requirements** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service… more
    Humana (11/20/25)
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