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... detecting and investigation of potential fraud and provide clinical guidance to ... reviewing of medical records for fraud, waste or abuse as well ... detecting and investigation of potential..
Description The Medicaid Oklahoma Pharmacy Director monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
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 Senior Fraud and Waste Investigator-- REMOTE/WORK AT ... looking for an experienced Senior Healthcare Investigator to join its industry ... have a passion for combating Fraud, Waste,..
Description Job Description Summary The Medicaid Oklahoma Pharmacy Director monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM ..
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 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 ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Tulsa Oklahoma Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Tulsa Oklahoma Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Tulsa Oklahoma Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible for the administration and monitoring of the Autism ..
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..
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 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 ..
