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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..
... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental..
Job Information Humana Medical Director - S. Florida in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Colorado Springs Colorado Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..
... social determinants and obtaining timely healthcare. The Lead Medical Director provides ... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... to BH..
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..
... with a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental expectations, and meets..
... whether services provided by other healthcare professionals are in agreement with ... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... with a..
Job Information Humana FP&A Lead, Medicaid Market in Colorado Springs Colorado Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
... 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,..
... 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,..
SCOPE The Behavioral Health Clinical Director is primarily responsible for leading and directing the organizations medically necessary services that are referred to the organization. This position will supervise the Behavioral Health ..
... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental expectations, and meets..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..