Medical/Financial Risk Evaluation Professional 2

5 hours ago

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

🌽 Illinois – Remote

Although this job is listed in Illinois, this company may be open to hiring remote in other states.

+2 more states

🏄 California – Remote 🌽 Illinois – Remote 🦬 Montana – Remote 🗿 South Dakota – Remote

💵 $65k - $88.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

💸 Financial Planning and Analysis (FP&A)

🦅 H1B Visa Sponsor

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Humana

WebsiteLinkedInAll Job Openings

Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

📋 Description

• Supporting the development, implementation and monitoring of medical/financial risk • Identifying, assessing, and mitigating any medical or financial risk arising from inadequate or failed processes, people, systems, or external events • Maintaining a balance between risk mitigation and efficiency • Making decisions regarding own work methods, occasionally in ambiguous situations, with minimal direction • Following established guidelines/procedures

🎯 Requirements

• Bachelor's degree • Experience with identifying and/or reporting fraud, waste and abuse within the healthcare industry • Knowledge of the Medicare and Medicaid programs • Experience in data analysis • 2 years of Humana Experience (preferred) • Knowledge of Humana Medical and Pharmacy Claims Processing Systems (preferred) • Experience with data query/data programming applications (i.e SQL, Python) (preferred) • Knowledge of data visualization tools (i.e. Power BI, QlikView, Tableau) (preferred)

🏖️ Benefits

• medical, dental and vision benefits • 401(k) retirement savings plan • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) • short-term and long-term disability • life insurance and many other opportunities