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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Boston Massachusetts Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
... (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..
Job Information Humana Director, Behavioral Health Strategy in Boston Massachusetts Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care for ..
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 Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Boston Massachusetts Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
... 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 Enterprise Risk Management Lead-US-Remote in Boston Massachusetts 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..
... 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..
Job Information Humana Bilingual Quality Auditor in Boston Massachusetts Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
... the BIDMC. The Senior Project Manager will oversee research study protocols ... IPCAVD program. The Senior Project Manager will interact routinely with physicians, ... the sponsor(s). The Senior Project..
Job Information Humana Manager, Fraud and Waste-Remote US in ... in Boston Massachusetts Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
... report builder to complete customer audit requests, with minimal supervision4.5 out ... degree required in Public Health, Healthcare Administration, Information Systems, Business Analytics, ... with Imprivata solutions or relevant..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Boston Massachusetts Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Quality & Analytics Manager, Home & Community Based Services ... a data-driven Quality & Analytics Manager to join the HCBS Waiver ... of HCBS Waiver Administration, the Manager will have..
... 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..
63780BRTitle:Financial Reporting Analyst IIDepartment:Finance-Financial ReportingAutoReqId:63780BRStatus:Full-TimeStandard Hours per Week:40 Job Category:FinanceJob Posting Description:The Finance Division positions itself to provide the best support to the U.S. News & World’s #1 Children’s Hospital in ..
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 ..
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 Boston Massachusetts Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
... the Data & Safety Monitoring Manager. n nThe ODQ Internal Auditing ... multi-center research.n Prepare for scheduled audit by thoroughly reading and understanding ... for the selected protocoln Conduct..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Boston Massachusetts Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..