• Disease Management Nurse I - 100% Virtual…

    Elevance Health (Chicago, IL)
    **Be Part of an Extraordinary Team** **_Carebridge Health_** _is a proud member of the Elevance Health family of companies, within our Carelon business. Carebridge ... Health exists to enable individuals in home and community- based settings to maximize their health, independence, and quality of life through home-care and community … more
    Elevance Health (09/12/25)
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  • Pre-Authorization Nurse

    Humana (Tallahassee, FL)
    …and Outlook + Work Tuesday - Saturday 8am-5pm EST, Overtime and Holidays based on business needs **Preferred Qualifications** + BSN + Bilingual English/ Spanish. ... round of interviews. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of… more
    Humana (09/13/25)
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  • Data Engineer

    Humana (Cheyenne, WY)
    …partners maximize program effectiveness and accuracy, which leads to improved member care, health outcomes, provider relationships, and financial sustainability for ... working in the multiple cloud ecosystem (ADLS/Databricks/ADF/ASA, Snowflake) or other cloud- based platforms. + Proven ability to work with cross-functional teams and… more
    Humana (09/12/25)
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  • Medical Director - Acute Rehab Team

    Humana (Baton Rouge, LA)
    …their daily work specifically for DSNP. The Medical Director's work includes computer- based review of moderately complex to complex clinical scenarios, review of all ... the care received by members in an assigned market, member population, or condition type. May also engage in...committees. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided… more
    Humana (09/11/25)
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  • Quality Compliance Professional

    Humana (Richmond, VA)
    …This is a remote position with travel. + **Travel:** Up to 25% to region- based providers to perform quality onsite audits and medical reviews. You may be required ... Time (EST). + **Assessment Statement:** Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment,… more
    Humana (09/11/25)
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  • Claims Research & Resolution Professional

    Humana (Lansing, MI)
    …claim submission processes and requirements claims denials, rework, and/or underpayments based on trended provider claims issues and common claims errors and ... clinical or post pay audit, authorization issues, check void/issue process, and member resources **Use your skills to make an impact** **Required Qualifications** +… more
    Humana (09/11/25)
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  • Claims Research and Resolution Professional

    Humana (Springfield, IL)
    …claim submission processes and requirements claims denials, rework, and/or underpayments based on trended provider claims issues and common claims errors and ... clinical or post pay audit, authorization issues, check void/issue process, and member resources **Use your skills to make an impact** **Required Qualifications** +… more
    Humana (09/10/25)
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  • Clinical Research Scientist 2

    Humana (Annapolis, MD)
    …that optimize healthcare delivery, lower medical cost while improve member health outcomes, through applying mathematical, statistical, epidemiologic and data ... other specific healthcare areas such as EMR, Episode grouper, utilization management, value- based care, low value care etc. **Additional Information** To ensure Home… more
    Humana (09/06/25)
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  • Technology Strategy Lead

    Humana (Oklahoma City, OK)
    …on conducting market scan on emerging AI/GAI technologies and capabilities. This team member will work closely with our AI Research & Development, as well as ... in the AI/GAI space + Prioritize areas to implement, based on deep understanding of opportunities and challenges at...is best for your schedule. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided… more
    Humana (09/06/25)
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  • Associate Director, Care Management

    Humana (Lansing, MI)
    …Human Services (MDHHS). + Ensures application of person-centered thinking, promoting member autonomy and independence. + Oversee appropriate data sharing between ... processes. + Ability to analyze and integrate information and make sound decisions based upon established guidelines. + Commitment to the creation of a collaborative… more
    Humana (08/27/25)
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