Job Details

Medical Financial Risk Evaluation Professional 2-Remote/Virtual in US

Company name
Humana Inc.

Location
Pittsburgh, PA, United States

Employment Type
Full-Time

Industry
Finance

Posted on
Jun 28, 2021

Apply for this job






Profile

Description

The Medical/Financial Risk Evaluation Professional 2 is responsible for supporting the development, implementation and monitoring of medical/financial risk. The Medical/Financial Risk Evaluation Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

Where you Come In

The Medical/Financial Risk Evaluation Professional 2 identifies, assesses, and mitigates any medical or financial risk that arises from inadequate or failed processes, people, systems, or external events. Maintains a balance between risk mitigation and efficiency. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

What Humana Offers

We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education.

Required Qualifications - What it takes to Succeed

Minimum of 2 years experience in Medicaid claims processes and regulations

Knowledge of Microsoft Excel, Word and PowerPoint

Strong research analysis skills and data analysis experience.

Preferred Qualifications

Bachelor's degree

CISPro and CIS knowledge

Technical experience: Previous Medicaid claims processing experience working in CAS

Medicaid contract review experience

SQL

Microsoft Access

Additional Information - How we Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parent Leave

Go365 perks for well-being

Work at Home/Remote Requirements

Must ensure designated work area is free from distractions during work hours and virtual meetings

Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com

Similar Jobs:
Senior Data and Reporting Analyst - Remote
Location : Pittsburgh, PA
Job Information Humana Senior Data and Reporting Analyst - Remote in Pittsburgh Pennsylvania Description The Senior Data and Reporting Analyst supports the success of Humana's Medicaid business by using workflow technology tools t...
Job Information Humana Senior Business Intelligence Engineer - Work at Home in Pittsburgh Pennsylvania Description The Senior Business Intelligence Engineer solves complex business problems and issues using data from internal and ...
Description The Specialist Programs Senior Value-Based Programs Professional supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior V...
EmploymentCrossing is great because it brings all of the jobs to one site. You don't have to go all over the place to find jobs.
Kim Bennett - Iowa,
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
FinancialServicesCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
FinancialServicesCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2024 FinancialServicesCrossing - All rights reserved. 21 192