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Job Information Humana Medicaid Associate Director, Compliance Nursing in Billings Montana Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
... (CCM) organization is seeking a Manager, Fraud & Waste to join ... join the Provider Payment Integrity-Clinical Audit team working remote anywhere in ... As the Fraud & Waste..
Description The Risk Management Professional 2 a critical member within Humana's Third Party Risk Management Program (TPRM), a 2nd Line of Defense function, will be responsible for maturing our program by ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... practices. Prepares complex investigative and audit reports. Begins to influence department's ... Qualifications Bachelor's degree or significant..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
... Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, ... Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2, ... include: Collaborate with the Quality..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Billings Montana Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Job Information Humana Manager, Fraud and Waste-Remote US in ... in Billings Montana Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Billings Montana Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Job Information Humana Enterprise Risk Management Lead-US-Remote in Billings Montana Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..
... is looking for an experienced Healthcare Investigator to join its industry ... billing practices. Prepares investigative and audit reports. Begins to influence department's ... areas Bachelor's degree or significant..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Billings Montana Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Billings Montana Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Job Information Humana Director, Behavioral Health Strategy in Billings Montana Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care for ..
... Accountable and Reports to: Pharmacy Manager/Head Pharmacist, Staff Pharmacist, Store Director, ... community and patients. Assists Pharmacy Manager/Head Pharmacist in coordinating workflow functions ... notebook as directed by Pharmacy..
... Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical ... in compiling and presenting your audit findings? If you answered YES ... production based environment of clinical..
Job Information Humana Communications & Sales Conduct Risk Management Lead-US-Remote in Billings Montana Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), ..