- R1 RCM (Boise, ID)
- …cash flows while reducing operating costs and enhancing the patient experience. As a Medicare Advantage Associate on our Revenue Recovery team, you will leverage ... your experience and expertise in complex Medicare Advantage payor methodology, payment screenings and experience maneuvering through various Patient Accounting… more
- R1 RCM (Boise, ID)
- As Operations Associate I in our Revenue Recovery Practice, you will leverage your experience and expertise in complex Medicare Advantage payor methodology, ... systems to deliver quality work products to R1' s clients. The Medicare Advantage Analyst is primarily responsible for researching underpayments as they relate… more
- Conviva (Boise, ID)
- …part of our caring community and help us put health first** The Associate Director, Security Architecture will play a key role in implementing security architecture, ... to ensure the enterprise can achieve the enterprise security strategy. The Associate Director, Security Architecture will play a key role in implementing security… more
- Humana (Boise, ID)
- …caring community and help us put health first** The Consumer Service Operations Representative 2 represents the Dual Eligible Outreach Department by taking inbound ... providers regarding a variety of issues. The Consumer Service Operations Representative 2 performs advanced administrative/operational/customer support duties that… more
- Humana (Boise, ID)
- …+ Minimum 1 year in a positionfocused on researching Regulatory Compliance for Medicare and/or Medicaid + Clinical Operations knowledge of Utilization Management ... . Responsibilities include: + Research new or emerging regulatory guidance ( Medicare and Medicaid): + Identify pertinent Utilization Management contractual and… more
- Humana (Boise, ID)
- …assignments. This position will focus on supporting Humana's senior-focused primary care operations . + Support growth and retention initiatives + Support review of ... law at a law firm or in-house health care organization + Experience in Medicare or similar regulatory work + Strong legal research, analytical, and writing skills +… more
- Humana (Boise, ID)
- …of our caring community and help us put health first** The Humana Enterprise Operations Enablement (EOE) - CPSS Data & Analytics - BI (Business Intelligence) team is ... data, data visualization and data science supporting Humana's Service Operations . The team is focused on converting data to...Apps and Power Automate + Knowledge of Medicaid and/or Medicare services + Advanced data analytics skills and reporting… more
- Humana (Boise, ID)
- …to make informed decisions + Support the daily management and operations of the department. Oversees utilization management functions which include timely ... team lead/SME or trainer/preceptor role + Health Plan experience + Previous Medicare experience a plus + MCG experience preferred **Work-At-Home Requirements** To… more
- Humana (Boise, ID)
- …health first** This position will focus on supporting Humana's home health care operations , which includes CenterWell Home Health, one of the largest home health ... law topics, such as fraud, waste and abuse; State licensing and Medicare and Medicaid enrollment; internal and external audits; healthcare related contracting; or… more
- Humana (Boise, ID)
- …user access in **Prisma portal** based on least privilege roles, and provide operations training and support, as needed. + Participate in a **24/7 on-call rotation** ... , leveraging **IaC automation** (Terraform) for efficient and secure cloud operations . + Proficiency in deploying and managing **NGFW policies** using **security… more
- Humana (Boise, ID)
- …community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy for pharmacy point ... of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional work assignments involve moderately complex to complex issues where… more
- Humana (Boise, ID)
- …information. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires ... an impact** **Required Qualifications** + A minimum of an Associate 's Degree + 5 or more years of experience...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Humana (Boise, ID)
- …position will manage a Provider Activation Team within the Provider Network Operations area under Provider Process & Services. The Manager role is strategic ... Quality + Analyze business metrics and provide monthly review of assigned business operations + Act as a Strategic Partner with Market Leadership and Service… more
- Humana (Boise, ID)
- …Essentials** + 7+ years of experience in clinical strategy and/or HealthPlan operations + Professional clinical license (eg, MD, Registered Nurse or Pharmacist) or ... etc.), with evidence of deep understanding of healthcare data and health-systems operations + Excellent written and verbal communication skills, with ability to… more
- Humana (Boise, ID)
- …the Professional will work to identify areas of opportunity to optimize business operations that improve productivity and efficiency. This body of work will span ... + Ability to analyze metrics and apply measurable outcomes to improve operations (may include time studies, AHT, sales performance, quality, etc..) + Partner… more
- Humana (Boise, ID)
- …partnership with Enterprise Security, Site Reliability Engineering, and IT Operations teams. + Perform troubleshooting, work through complex requirements/solutions, ... industries (Healthcare, Banking, Cybersecurity) **Additional Information** Solid understanding of operations , technology, communications and processes Must be passionate about… more
- Humana (Boise, ID)
- …of a Senior Business Systems Analysis Professional to be a liaison between operations and IT and assist in making decisions on testing features/functionality of our ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boise, ID)
- …Strategy Officer, who also oversees the Corporate Development and Strategy Operations teams. **Job Description** The Corporate Strategy Consultant - Strategy ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boise, ID)
- …to make an impact** **Required Qualifications** + Minimum 5 years of consumer operations lead and/or process improvement experience + Minimum 2 years of project ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Humana (Boise, ID)
- …Scheduling will manage all scheduling processes in support of call center operations to achieve optimal resource utilization in accordance with service performance ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more