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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 Senior Risk Management Professional will be responsible for managing third party risk management (TPRM) work streams to support Humana's overall TPRM Program. Responsibilities include risk identification, data analysis, process ..
... Information Humana Medicaid Associate Director, Compliance Nursing in Bethesda Maryland Description ... Maryland Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g. CPT) to patient records. The Medical Coding Auditor ..
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 Medical Coding Auditor - Outpatient & Surgical Specialty ... Maryland Description The Medical Coding Auditor reviews medical claims submitted against ... CPT, HCPCS). The Medical Coding Auditor..
Description The Compliance Nurse 2 reviews utilization management ... fraud, waste, and abuse. The Compliance Nurse 2 work assignments are ... appropriate courses of action. The Compliance Nurse 2 will..
Job Information Humana Bilingual Quality Auditor in Bethesda Maryland Description The ... Maryland Description The Bilingual Quality Auditor/ Professional 2 ensures that products ... ensure accuracy. Responsibilities Bilingual Quality Auditor/..
Description The Senior Compliance Professional ensures compliance with governmental requirements, specifically risk ... clinics including serving as a compliance subject matter expert for revenue ... value-based care programs. The Senior..
... looking for an experienced Senior Healthcare Investigator to join its industry ... a thorough investigation to maintain compliance with Humana and governmental requirements ... external partners (Law Enforcement, Legal,..
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 ..
... is looking for an experienced Healthcare Investigator to join its industry ... a thorough investigation to maintain compliance with Humana and governmental requirements ... external partners (Law Enforcement, Legal,..
Job Information Humana HCS Compliance & Risk Management Quality Audit ... action. Responsibilities As a HCS Compliance & Risk Management Quality Audit ... be responsible for executing the Compliance Oversight..
Description The DRG Validation Auditor extracts clinical information from a ... patient records. The Medical Coding Auditor work assignments are varied and ... action. Responsibilities The DRG Validation Auditor confirms..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities Seeking Senior..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... Healthy Horizons Mental Health Parity Compliance..
Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..
Job Information Humana Senior Risk Management Professional - Third Party Risk Management-Remote, US in Bethesda Maryland Description The Senior Risk Management Professional a critical member within Humana's Third Party Risk Management ..
