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Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
... health. Dedicated to simplifying the healthcare experience and helping people navigate ... and helping people navigate their healthcare journey, Author is leveraging digital ... a new path for the..
Job Information Humana Senior Risk Management Professional - Third Party Risk Management-Remote, US in Troy Michigan Description The Senior Risk Management Professional a critical member within Humana's Third Party Risk Management ..
... with other members of the healthcare team to plan, implement and ... directed, implements external and internal audit recommendations. Ensures hospital departments achieve ... Care Administration, Business Administration, clinical..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..
... new addresses, if necessary. Review, audit and process employer group enrollment ... group and/or agent when applicable. Audit out-of-area (OOA) enrollment to ensure ... consultation to PHP Business Systems..
... implement and maintain clinical lab audit concepts. The Nurse Auditor 2 ... Auditor 2 will perform clinical audit and validation processes to ensure ... implement and maintain clinical lab..
... 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..
... prepares detailed specifications from which healthcare application programs will be selected; ... concise documentation, instruction manuals, and audit trails of program changes in ... Minimum of one year previous..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Troy Michigan Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
Description Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
Job Information Humana Communications & Sales Conduct Risk Management Lead-US-Remote in Troy Michigan Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), ..
Job Information Humana Enterprise Risk Management Lead-US-Remote in Troy Michigan Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..
Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..
Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..
... in all phases of the audit process including evaluating control design ... 5 or more years of healthcare revenue cycle management experience may ... with Auditing and monitoring of..
... 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..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
