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Job Information Humana Healthcare Data Analyst in Louisville Kentucky Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. ..
Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team working remote/from home anywhere in the U.S. Responsibilities As a Board Certified ..
Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Louisville Kentucky Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible for the administration and monitoring of the Autism ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Louisville Kentucky Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Louisville Kentucky Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..
Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The Nurse ..
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 ..
Job Information Humana Fraud and Waste Investigator - Work ... is looking for an experienced Healthcare Investigator to join its industry ... have a passion for combating Fraud, Waste, and..
Job Information Humana Associate Director, Fraud and Waste in Louisville Kentucky ... for the management of the Fraud and Abuse staff in discovery, ... discovery, development, and coordination of fraud..
Description The Senior Clinical Fraud and Waste Professional performs analysis ... abusive practices. The Senior Clinical Fraud and Waste Professional work assignments ... factors. Responsibilities The Senior Clinical Fraud and..
... mission of supporting the TRICARE healthcare program for our nation's military? ... the team responsible for identifying fraud and abuse in TRICARE billings ... Defense Health Agency to substantiate..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Description This is a salaried exempt position with responsibility for utilization management oversight and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in the TRICARE Operations Manual Chapter ..
