Healthcare Compliance Auditor Jobs in Troy

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 Troy Michigan Description ... Michigan Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..

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 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 ..

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 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 ..

... 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,..

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 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..

Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Michigan Description The Medical Coding Auditor reviews medical claims submitted against ... CPT, HCPCS). The Medical Coding Auditor..

Job Information Humana Licensed Behavioral Health Professional - Quality Audit in Troy Michigan Description Humana Healthy Horizons in Ohio is seeking a Licensed Behavioral Health Quality Audit Professional. This position ensures ..

... 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 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..

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 Compliance Registered Nurse in Troy Michigan ... Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory ... timely and accurately. Responsibilities Senior Compliance Nurse..

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..

Job Information Humana Clinical Auditor Registered Nurse Care Management or ... is completed. Conducts and summarizes compliance audits. Responsibilities The Clinical Auditor for the Care and or ... physician office,..

Job Information Humana Bilingual Quality Auditor in Troy Michigan Description The ... Michigan Description The Bilingual Quality Auditor/ Professional 2 ensures that products ... ensure accuracy. Responsibilities Bilingual Quality Auditor/..

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 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..

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 ..