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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 Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
... 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..
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 ..
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 ..
... 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,..
... 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 Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Dover Delaware Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
Job Information Humana FP&A Lead, Medicaid Market in Dover Delaware Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
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..
... 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..
... 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..
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 Job Description Summary 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 ..
... fraud, waste, and abuse (FWA) compliance program to prevent and detect ... out the provisions of the compliance plan, including FWA policies and ... Oversee internal investigations of FWA..
