- Humana (San Juan, PR)
- …The focus of this role is Medicare Pharmacy and Part D. The Senior Compliance Professional will analyze business requirements, provide research and ... caring community and help us put health first** The Senior Compliance Professional ensures ...Compliance or Health Plan Operations + Familiarity with Medicare pharmacy laws or regulations **Additional Information** Interview Format… more
- Humana (San Juan, PR)
- …community and help us put health first** Humana Healthy Horizons is seeking a Senior Compliance Professional to support audit preparation, internal controls ... and compliance efforts across the organization. The Senior Compliance Professional work assignments...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- CenterWell (San Juan, PR)
- …part of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve...will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for … more
- Humana (San Juan, PR)
- …between Humana and its trading partners, Medicare and Medicaid. The Senior Encounter Data Management Professional will work with department leadership, ... caring community and help us put health first** The Senior Encounter Data Management Professional develops business...Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools… more
- Humana (San Juan, PR)
- …providing frameworks to maximize available resources to achieve growth. The ** Senior Professional Business Intelligence Engineer** is an experienced individual ... a proven track record of leveraging data to meet compliance requirements and define and drive business value. The... requirements and define and drive business value. The Senior Professional will partner across various multi-disciplinary… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Senior Technology and Cybersecurity Risk Professional defines the standard for Humana's ... risk management approach, and identifies and reports on related risk. The Senior Technology and Cybersecurity Risk Professional work assignments involve… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Senior Vendor Management Professional works as liaison between vendors and organization. The ... Senior Vendor Management Professional work assignments involve...Monitor performance against key performance indicators (KPIs) and ensure compliance with contractual commitments and requirements. Partner with health… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Senior Contract Management Professional evaluates, drafts, and negotiates contracts and other ... of goods and services for Humana, its subsidiaries and affiliates. The Senior Contract Management Professional work assignments involve moderately complex to… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Senior Enterprise Transformation Professional manages all aspects of a large-scale program, ... to finish, so that it is completed on time and within budget. The Senior Enterprise Transformation Professional will solutionize across teams to solve moderately… more
- Humana (San Juan, PR)
- …initiatives across transformation initiatives. Through discovery, analysis and findings, the Senior Professional will work to identify areas of opportunity ... to optimize business operations that improve productivity and efficiencies. The Senior Professional will exercise considerable latitude in determining objectives… more
- Humana (San Juan, PR)
- …community and help us put health first** Humana Healthy Horizons is seeking a Senior Program Delivery Professional to support quality program work in multiple ... Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS). The Senior Program Delivery Professional (LTSS - Quality) works on problems… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of ... data requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis… more
- Humana (San Juan, PR)
- …part of our caring community and help us put health first** The Senior Data Visualization Engineer builds user interfaces, visualizations, and data algorithms. Takes ... and ultimately enable them to make the better business decisions. The Senior Data Visualization Engineer work assignments involve moderately complex to complex… more
- Humana (San Juan, PR)
- …help us put health first** We are seeking a talented and motivated Senior Cognitive/Machine Learning Engineer to join our dynamic team. The traditional candidate ... machine learning and emerging generative AI technologies. As a Senior Cognitive/Machine Learning Engineer, you will play a key...related field) with a minimum of 5 years of professional experience; OR + Master's Degree in a similar… more
- Humana (San Juan, PR)
- …our caring community and help us put health first** The Learning Design Professional 2 uses instructional design, cognitive psychology and adult learning theory to ... to a knowledge or performance gap. The Learning Design Professional 2 work assignments are varied and frequently require...are current and relevant to training needs. + Assists senior and lead to track and analyze the training… more
- CenterWell (San Juan, PR)
- …care initiatives designed to improve quality and reduce costs for high-risk senior populations in full-risk Medicare arrangements. This role will focus ... portfolio within the Complex Care vertical of centralized programming to serve CenterWell Senior Primary Care's (and Conviva Senior Primary Care's) highest need… more
- CenterWell (San Juan, PR)
- …non-technical audiences. **Preferred Qualifications** + Master's degree + Experience in senior -focused or Medicare Advantage care models, especially within ... + Define and track KPIs to measure product success, communicate progress to senior leadership, and adapt to evolving priorities. + Ensure compliance with… more
- Humana (San Juan, PR)
- …teams in support of Humana's Insurance Business. This position reports to the Senior Vice President, Provider Experience and will lead an organization of 300+ ... development/provider relations function, including proven experience leading contracting for Medicare products. He/she will possess comprehensive knowledge of health… more
- Humana (San Juan, PR)
- …recommendations. + Present complex analytical findings and model outputs to senior leaders and non-technical stakeholders, focusing on clear data storytelling. + ... ensure holistic and informed strategy development. + Maintain a deep understanding of Medicare Part D benefit design and regulatory changes to inform forecasting and… more
- Humana (San Juan, PR)
- …first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer ... it expands to accommodate the increased responsibilities. **Responsibilities:** The Senior Business Intelligence Engineer will be primarily responsible for… more