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Humana Genetic Counselor (Board Certified) (Remote US) in Kansas City, Missouri

Description

Humana is seeking a Genetic Counselor to assist in the detecting and 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.

Responsibilities

Humana is seeking a Genetic Counselor to assist in the detecting and 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.

Required Qualifications

  • 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 or related role

  • 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

Preferred Qualifications

  • 3 or more years’ 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

At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few:

  • Work-Life Balance

  • 100% Work-At-Home/Remote

  • Generous PTO package

  • Health benefits effective day 1

  • Annual Incentive Plan

  • 401K - Immediate company match

  • Well-being program

  • Paid Volunteer Time Off

  • Student Loan Refinancing

If you share our passion for helping people, we likely have the right place for you at Humana.

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

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.

Humana Safety and Security

Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailboxtasrecruit@humana.com to validate the request.

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