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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 ..
Description Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of a ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Pittsburgh Pennsylvania 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 ..
... 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 Communications & Sales Conduct Risk Management Lead-US-Remote in Pittsburgh Pennsylvania Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), ..
Job Information Humana Senior Risk Management Professional - Third Party Risk Management-Remote, US in Pittsburgh Pennsylvania Description The Senior Risk Management Professional a critical member within Humana's Third Party Risk Management ..
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 ..
... 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 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 ..
AccentCare is looking for passionate clinicians committed to delivering exceptional care in the home.We are committed to quality patient outcomes—delivering evidence-based care in the home—and providing comprehensive training to further develop ..
... 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..
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 ..
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 ..
Job Information Humana Enterprise Risk Management Lead-US-Remote in Pittsburgh Pennsylvania Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..
Job SummaryThe Medical Director, Health Services along with the Vice President, Medical Operations, is directly responsible for all Plan activities related to the member. He/she will be dedicated to the goals ..
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 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 ..
... 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..
... reducing waste and overuse of healthcare services, while encouraging high value ... Trend (CAT) team needs your healthcare, analytic, and research acumen to ... have the opportunity to support..
