• Utilization Management Registered Nurse

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... + Bachelor's degree + Previous experience in prior authorization, claims , and/or utilization management in healthcare, health insurance, evaluating medical… more
    Humana (09/04/25)
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  • Medical Director - National Medicare

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
    Humana (09/04/25)
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  • Medicaid State Technology Lead

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... processes + Solid understanding of healthcare operations, particularly around claims processing, enrollment, provider data management and clinical operations;… more
    Humana (09/03/25)
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  • Medicaid Pricing Actuary

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... either the state agency or payer perspective + Detailed understanding of healthcare claims Travel: While this is a remote position, occasional travel to Humana's… more
    Humana (08/27/25)
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  • Care Management Support Assistant

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... on beneficiary needs; assists with beneficiary related issues which may include claims inquiries, enrollment issues, travel attestations, access to care, wait lists,… more
    Humana (08/27/25)
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  • Medical Director - Medicare Grievances and Appeals…

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of… more
    Humana (08/26/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must… more
    Humana (08/23/25)
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  • Medical Record Retrieval Representative

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... meet all deadlines + Remote access record retrieval via electronic systems + Research claims and provider information for accurate retrieval + Travel up to 20% of… more
    Humana (08/21/25)
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  • Senior Capture Manager

    Mass Markets (VA)
    …Savings:Secure your future with retirement savings programs, where available. + Disability Insurance:Short- term disability coverage is available to ... 12-18+ months ahead of RFP releases while also supporting short- term capture opportunities as needed. + Provide insights and...largely sedentary and will be required to sit/stand for long periods while using a computer and telephone headset.… more
    Mass Markets (08/12/25)
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  • Medical Director - Medicare Grievances and Appeals…

    Humana (Richmond, VA)
    …off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability , life insurance and many ... The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems of… more
    Humana (08/08/25)
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