- Trustmark (Lincoln, NE)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
- Humana (Lincoln, NE)
- …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 (Lincoln, NE)
- …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
- Cardinal Health (Lincoln, NE)
- …products are used. **What this position contributes to Cardinal Health:** The Associate Director, Access and Patient Support (APS) is responsible for the tactical ... of collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Trustmark (Lincoln, NE)
- …benefits products (ie, sales, implementation and enrollment, underwriting, billing, servicing, claims ) using DMAIC, PDCA, etc. methods. Develop the approach and ... office in Lake Forest, IL for 3 days. Fully remote candidates are also welcome to apply.*_** Brand: Trustmark...FSA and HSA, 401(k) plan, Employee Assistant Program, Back-up Care for Children, Adults and Elders and many health… more
- Humana (Lincoln, NE)
- …functionality and payment methodologies to the Operations staff. + Work with non-Operations _i_ Care staff to learn about new _i_ Care products, processes and ... support company collaboration. + Assist Operations staff with daily claims , enrollment and provider services issues in a manner...available resources. (ie DHS and CMS websites, contracts, _i_ Care brochures, _i_ Care policies and procedures,… more
- Humana (Lincoln, NE)
- …for our members and providers, all while driving health outcomes and cost-effective care for our members. We are seeking a Clinical Investigation Lead to provide ... strategic direction to drive appropriate care , with the aim of reducing waste and overuse...to bring forth a pipeline of potential initiatives. **Location:** remote In this lead role you'll have the opportunity… more
- Humana (Lincoln, NE)
- …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
- Humana (Lincoln, NE)
- …apply clinical and coding experience to conduct reviews of medical claims . Understands department, segment, and organizational strategy and operating objectives, ... **Use your skills to make an impact** **WORK STYLE:** Remote /Work at home with the possibility of minimal travel...conferences. **WORK HOURS:** Must start between 6AM-9AM in the associate 's own time zone. Typical business hours are Monday-Friday,… more
- Humana (Lincoln, NE)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... 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 **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Lincoln, NE)
- …researches/reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or recovery. Analyzes, enters ... knowledge. **Use your skills to make an impact** **WORK STYLE:** 100% remote /work at home. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day,… more
- Humana (Lincoln, NE)
- …for complex accounts + Experience analyzing a wide variety of health or claims related data **Additional Information** **Why Humana?** At Humana, we know your ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more