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The Functional Screen Specialist assesses the functional status and eligibility of Family Care members using a State health tool. Responsibilities include scheduling, conducting face-to-face interviews, maintaining documentation, and coordinating with Member Support Coordination staff. This role also involves crisis intervention referrals and participation in quality assurance activities.
The Senior Acquisition Integration Consultant manages the integration of acquired entities, focusing on project management and collaboration with stakeholders. Responsibilities include influencing departmental strategy, resolving complex issues, and ensuring the alignment of project objectives with the organization’s vision.
The LTSS Provider Education & Outreach Representative manages relationships with LTSS and HCBS providers in Indiana, ensuring their understanding of Humana policies and systems, overseeing onboarding and training, responding to inquiries, and organizing meetings to enhance provider experience and retention.
The Senior Campaign Development Engineer resolves complex campaign-related issues using data analysis to create population lists, develop automated workflows, and influence strategic decisions. This role requires advanced knowledge of healthcare data and experience in leading teams to improve consumer experiences through insightful data presentation and analysis.
The Provider Contracting Executive negotiates and executes contracts with healthcare providers, communicates contract terms, analyzes financial impacts, and maintains documentation. The role requires project leadership and skills in provider contracting, with minimal supervision and independent decision-making.
The Grievances & Appeals Representative 3 manages client denials and concerns through comprehensive reviews of clinical documentation, determining if grievances or appeals are warranted. They assist members with quality goals, investigate issues, and perform administrative tasks, utilizing strong data entry skills and experience in the healthcare field. Regular discretion in prioritizing requests is required, along with effective communication skills.
The Case Manager Assistant supports care management by assisting in non-clinical tasks such as assessing members' needs, reviewing medical records, ensuring compliance with care plans, and communicating with staff regarding any deficiencies. They also analyze data for quality improvement and assist in connecting members with appropriate resources.
The Coding Educator 2 improves provider documentation in the North East region by creating tailored education plans, reviewing medical records, and conducting educational sessions for providers and office staff. They collaborate with various departments to enhance quality care and document processes, often working independently on complex issues.
As a Senior Application Architect, you will design and develop robust, scalable application architectures, collaborating with teams to align software solutions with business goals. You will review emerging technologies, define performance metrics, and guide on application modernization to improve efficiency while ensuring code quality and performance.
The Senior Professional in Content & Campaign Planning at Humana is responsible for leading content creation for marketing campaigns, interfacing with various teams, and employing analytics and AI to optimize campaigns. This role requires collaboration with internal stakeholders to create effective, multi-channel marketing initiatives that align with organizational goals.
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