Location: All Humana and External; Work from home in any location
Be a part of our Clinical Space – as a Genetic Counselor you will engage our members to develop lifelong wellbeing and health.
Humana’s dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference. Our associates know their work is vitally important; we strive to ensure we provide perfect service with one-on-one member interactions as a coach, personal nurse, or clinical advisor Humana’s Perfect Service® means getting the basics done right, delivering value and quality, providing guidance on needs, and being engaged with our members. We want to help our members make the right choices to live life fully. We begin that process by connecting our members with an associate who cares.
Humana is seeking a Genetic Counselor to assist in the detecting and investigation of potential fraud, waste or abuse and provide clinical guidance on 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.
Master’s Degree of Science in Genetic Counseling
Active license in the state requiring licensure
Proven successful experience in completing efficiencies and 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
Board Certified Genetic Counselor
Experience in hereditary cancer counseling/testing as well as experience with somatic cancer panels is a plus
3 -5 years or more of experience in genetic counseling or related role
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
Familiarity with CMS and/or Humana regulatory policies
Internal Number: 186927
Humana: A history of innovation
Throughout our history, Humana has always been one step ahead, constantly evolving with the changing world of healthcare. It is our proactive, forward-thinking approach that has allowed us to not only meet the needs of our customers, but also provide a challenging and exciting work experience for our associates.
What's important to us
Drawing on more than 50 years of experience , we push forward with a noble purpose that inspires and instills pride. When it comes to helping people achieve lifelong well-being, the possibilities are endless. We're always looking for innovative ways to reach our customers where they are, to know them as individuals and to engage them in ways that are meaningful. To be truly successful, we need to create an emotional connection with people. When we achieve that, they benefit, and so does Humana.
Humana recognizes that each associate is unique, and we encourage you to unlock your potential by applying your skills, leveraging your strengths, and pursuing your interests. We give you the tools, the knowledge, the guidance, and the freedom to get involved right from the start. We not only seek di...versity in culture and heritage but in experience and knowledge. We know that seeing a situation from a different perspective often leads to better solutions.