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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 Las Vegas Nevada Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
... The Associate Director for ACD Audit , at the director of ... Orders, for ACD Program Integrity Audit; driving to operational excellence, repeatable ... system needs, data needs, provider..
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 ..
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 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 Manager, Fraud and Waste-Remote US in ... Las Vegas Nevada Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Job Information Humana MRA Physician Lead - CenterWell - Las Vegas, NV in Las Vegas Nevada Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for ..
Job Information Humana Director, Behavioral Health Strategy in Las Vegas Nevada Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care ..
... (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 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 Las Vegas Nevada Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ..
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 ..
... 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..
... 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 Outpatient Medical Coding Auditor-Remote/Virtual in US in Las Vegas Nevada Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Las Vegas Nevada Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns ..
... 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 Las Vegas Nevada Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Job Information Humana Physician Lead - CenterWell - Las Vegas, NV in Las Vegas Nevada Description Humana's Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused ..
... Medical Coding Auditors Assists the Audit Manager with data analysis, team management, ... guidelines Prepares written summaries of audit findings Presents verbal audit feedback and provides education upon .....