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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 ..
Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Chicago Illinois Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
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 ..
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 ..
... 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..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Chicago Illinois Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
... 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 Director, Behavioral Health Strategy in Chicago Illinois Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care for ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Chicago Illinois Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... schedules and goals. Responsibilities The Manager, Care Management supervises,..
... (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 Inpatient Medical Coding Auditor-Remote/Virtual in US in Chicago Illinois Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Job Information Humana Manager, Care Management (Illinois Medicaid) - ... in Chicago Illinois Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management..
Job Information Humana Enterprise Risk Management Lead-US-Remote in Chicago Illinois Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..
... 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..
... 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 Outpatient Medical Coding Auditor-Remote/Virtual in US in Chicago Illinois Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
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 ..
Job Information Humana Bilingual Quality Auditor in Chicago Illinois Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
Job Information Humana Communications & Sales Conduct Risk Management Lead-US-Remote in Chicago Illinois Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), ..
Job Information Humana Manager, Fraud and Waste-Remote US in ... in Chicago Illinois Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud 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, CPT) to patient records. The Medical Coding ..
