14 family medicine jobs found

Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area. Independently sets priorities and makes decisions on work approach while following established direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Humana's Encounter Data Management (EDM) team is seeking an Encounter Data Management Professional that has experience with business processing and data...

Become a part of our caring community and help us put health first Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary. KEY ACCOUNTABILITIES Assist beneficiaries with...

Become a part of our caring community and help us put health first Humana is evolving its marketing operations to enable smarter planning, faster execution, and greater transparency-and we're looking for a product manager to lead that effort. As Senior Associate/Product Manager - Marketing Resource Management (MRM) Capabilities, you'll own the roadmap for tools and workflows that support campaign intake, planning, approvals, and performance tracking. This role is central to enabling scalable, compliant, and insight-driven marketing operations. You'll help guide the transition to a modern resource management platform and evaluate opportunities to integrate with enterprise workflow systems to support intelligent orchestration. This role supports the day-to-day configuration and optimization of marketing resource management tools and workflows. You'll work closely with cross-functional teams-including Marketing, Creative, Legal, and IT-to ensure campaign planning and...

Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Lead Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Lead Product Owner works on problems of diverse scope and complexity ranging from moderate to substantial. This role will be aligned to Humana sales technology platforms, helping further advance capabilities that provide a seamless...

Become a part of our caring community and help us put health first The Associate Director, Finance Data Management supports all aspects of configuration control, data management, and deficiency reporting. The Associate Director, Finance Data Management requires a solid understanding of how Finance organization data capabilities interrelate across department(s). The Associate Director, Finance Data Management supports implementation of government and industry policies for requirements management, document management, change management, production and delivery, and configuration management of the performance, functional, and physical baselines. Acquires, validates, stores, protects, and processes required data to ensure the accessibility, reliability, and timeliness of the data for its users. Develops and executes architecture, policies, practices and procedures that properly manage the full data lifecycle needs of an enterprise. Decisions are typically related to identifying...

At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more at https://www.jnj.com Job Function Pharmaceutical Sales Job Sub Function Sales – Neuroscience (Commission) Job Category People Leader All Job Posting Locations: Columbia, Missouri, United States, Fort Wayne, Indiana, United States, Indianapolis, Indiana, United States, Kansas City, Kansas, United States, Louisville, Kentucky, United States, Rockford, Illinois, United States, Springfield, Illinois, United States, Springfield, Missouri, United States Job Description...

Become a part of our caring community and help us put health first At Humana, we are focused on the elimination of unjust, avoidable and unnecessary barriers in health and health care. The Data Manager 2 (DM2), reporting to the Health Equity Strategy Lead, supports the whole-person, integrated care model for members in our Medicaid and Medicare market to help build the toolkit for equitable population health. In particular, we partner with executives, managers and other leads to advance Care Management, Quality Improvement, Community Engagement, Marketing, Health Economics and Finance to bring a greater understanding of factors that apply to wellbeing from a view of physical, behavioral and spiritual health. The Data Manager 2 supports all aspects of configuration control, data management, and deficiency reporting. The Data Manager 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action....

Become a part of our caring community and help us put health first The Customer Success Manager is a key leadership role responsible for ensuring customer retention through proactive engagement, strategic initiatives, and operational excellence. This role works collaboratively to ensure alignment and consistent performance, managing up to 25 Customer Success Agents to deliver on retention objectives and test new business initiatives. The Customer Success Manager plays a critical role in driving customer retention through proactive engagement with customers and the implementation of strategic retention initiatives. In addition to core retention campaigns and allegation mitigation, the role supports Call Quality for their team, contributes to broader enterprise value by test & learning new initiatives, and can be part of building something from the ground up. The Customer Success Manager should be ready to receive objectives and determine approach, resources, goals, and...

Become a part of our caring community and help us put health first The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Where You Come In The Manager, Fraud and Waste coordinates investigation with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for CVS Health. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And...

Become a part of our caring community and help us put health first The Senior Product Manager Conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Senior Product Manager is a senior individual contributor who orchestrates complex, cross-platform technology initiatives that advance enterprise strategy and operational reliability. As a Senior Product Manager, you will plan and manage the enhancement and/or integration of the business products with a special focus on clinical care management and technology solutions. This role is pivotal in translating business vision into scalable technology solutions, ensuring seamless integration across platforms such as clinical care management platforms, telephony, data systems, and enterprise architecture. The Senior Product Manager will...

Become a part of our caring community and help us put health first The Care Manager, Telephonic Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. The Care Manager Telephonic Nurse uses clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their...

Become a part of our caring community and help us put health first The Field Marketing Executive plays a crucial role in driving lead generation and supporting the local sales team through grassroots marketing, community outreach, and event execution. The Field Marketing Executive works directly in the field to identify opportunities, build relationships, and activate strategies that contribute to sales growth, branding, and increased community presence. Ultimately, the Field Marketing Executive contributes to market growth objectives. The Field Marketing Executive works with agents and their leaders to create plans that drive new enrollments, increase retention of existing members, and build meaningful relationships with community organizations and influencers. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable...

Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries...