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Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Family Physicians Group (FPG) and Partners in ..
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 Springfield Missouri Description ... Missouri Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
... 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,..
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 Senior Risk Management Professional - Third Party Risk Management-Remote, US in Springfield Missouri Description The Senior Risk Management Professional a critical member within Humana's Third Party Risk Management ..
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..
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 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 ..
... 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 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 Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and 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 ..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Missouri Description The Medical Coding Auditor reviews medical claims submitted against ... CPT, HCPCS). The Medical Coding Auditor..
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..
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..