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.
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.
+ **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
+ Proven successful experience in completing efficient
health-related research, with associated analysis and
+ 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
**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
+ 3 or more years' experience in the health industry, to include
knowledge of CPT code billing.
+ Experience with research, analysis and root cause
+ Development of clinical and /or coding concepts and
+ Proficiency with Excel
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
+ 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.
**Scheduled Weekly Hours**