Be a part of our Clinical Space – as a Genetic Counselor you will engage our members to develop lifelong well-being 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 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
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
Board Certified Genetic Counselor
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 Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.