- Humana (Washington, DC)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient ... communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or… more
- Takeda Pharmaceuticals (Washington, DC)
- …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- The Cigna Group (Annapolis, MD)
- …have a background in customer service or experience in healthcare, specifically benefits and claims processing, you might be the perfect fit to join our team as a ... Care Navigator Representative. As a Care Navigator,...driving a consistently accurate quality of service. **QUALIFICATIONS:** + Associate degree or higher required and/or 4+ years' work… more
- Abt Global Inc. (Rockville, MD)
- …career and their experience conducting research on post-acute care , nursing home health care policy, and health care claims data to play key technical ... homes or other post-acute care settings, health care policy. + Use Medicare claims data...Abt Global will never ask candidates for money in exchange for an offer of employment. _ _\#LI-CO1_ #LI- Remote … more
- Humana (Washington, DC)
- …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes,...**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Humana (Washington, DC)
- …first** Humana's Clinical Analytics Team is seeking a Lead Research Scientist ( Remote ). Healthcare is rapidly changing, and our members are living longer, often ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
- Amgen (Washington, DC)
- …in the public or private third-party access arena or pharmaceutical industry in managed care , clinical support, and/or sales OR Associate degree AND 10 years of ... insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution + Educate offices using approved materials + Review… more
- Humana (Washington, DC)
- …first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position \#LI- Remote **Scheduled Weekly Hours** 40… more
- Humana (Washington, DC)
- …working with health insurance operations related data to include enrollment, claims , billing and Reconciliation and/or contact center (Call center) data **Additional ... Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring...(collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and… more
- CVS Health (Falls Church, VA)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. **Position Summary** Applicants must reside… more
- Amgen (Washington, DC)
- …with real-world data (RWD) such as electronic health records (EHR) and claims data; providing trial activities at non-traditional sites, including virtual visits, ... the biopharmaceutical industry or equivalent health sciences field. Or Associate 's degree and 10 years of experience in digital...us** As we work to develop treatments that take care of others, we also work to care… more
- Amgen (Washington, DC)
- …**Or** Bachelor's degree and 4 years of experience in a quantitative field **Or** Associate degree and 8 years of experience in a quantitative field **Or** High ... eg, clinical trial data, electronic medical records, and insurance claims ; or Bioscience's data, eg, protein or small molecule...us** As we work to develop treatments that take care of others, we also work to care… more
- Humana (Washington, DC)
- …Degree + CAS, MTV, PAAG, or APEX systems experience + Claims experience + Provider data management data loading/analysis/review **Additional information** ... ongoing interruptions to protect member PHI / HIPAA information. This is a remote position \#PPNO **Scheduled Weekly Hours** 40 **Pay Range** The compensation range… more
- Compass Group, North America (Washington, DC)
- …the location HRIS system + Ensuring the timely processing of all unemployment claims + Plans the team's activity to deliver against medium-term objectives + Managing ... in a Human Resources leadership role + Experience leading remote teams is preferred + Experience managing large scale...At Levy, team = family. And we'll always take care of family, learn more about Levy benefits offered.… more