Description
Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit – Clinical Review team working remote/from home anywhere in the U.S.
Responsibilities
Where you Come In
As a Board Certified Genetic Counselor you will assist in the detecting and the investigation of potential fraud and provide clinical guidance to the Special Investigators handling the cases. This is an inward facing role, with no direct member interaction. The daily assignment capsule includes reviewing of medical records for fraud, waste or abuse as well as review of Humana Medical Coverage Policies, CMS regulations, peer reviewed literature, and professional society’s publications for applicable regulations.
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
Master’s Degree of Science in Genetic Counseling
Active license in the state requiring licensure
Board Certified Genetic Counselor
3+ years of experience in genetic counseling
Proven successful experience in completing efficient health-related research, with associated analysis and conclusions
Excellent organizational skills desired with ability to handle multiple tasks and deadlines with attention to detail
Self-starter with the ability to work independently
Excellent written and oral communication skills required
We will require full COVID vaccination for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve.
If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law.
Preferred Qualifications
Experience in the health industry, to include knowledge of CPT code billing
Experience with research, analysis and root cause identification
Development of clinical and /or coding concepts and processes
Proficiency with Excel
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
Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work.
Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10M x 1M
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.
#ThriveTogether #WorkAtHome
Scheduled Weekly Hours
40
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