Healthcare Fraud Management Jobs in Idaho

... Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Associate ... and quality performance and staffing..

... customer experience, continuous improvement, change management, data integrity and process-level measurements. ... 10% Working with ACD Care Management operational leaders, lead development of ... objectives. Required Qualifications Experience in..

Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..

Description The Manager, Fraud and Waste, Genetic Counseling provides ... and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works ... and goals. Responsibilities The Manager, Fraud and Waste,..

Job Information Humana Manager, Fraud and Waste-Remote US in Meridian ... Meridian Idaho Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..

Job Information Humana Manager, Fraud and Waste-Remote US in Boise ... Boise Idaho Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..

... Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Supervisor, ... solve basic problems; collaborates with..

Description Humana's Claims Cost Management (CCM) organization is seeking a ... organization is seeking a Manager, Fraud & Waste to join the ... in the US. As the Fraud &..

... The Compliance Nurse reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Compliance ... plus Previous experience in utilization..

... Qualifications 3 plus years of healthcare fraud investigation experience 2 plus years ... knowledge and experience Experience in healthcare or in a managed care ... raw data and recommendations..

... and clinical compliance, and case management. Serve as a Humana Military/Humana ... for quality standards, claims accuracy, fraud, and required clinical elements. Perform ... clinical elements. Perform telephonic case..

Healthcare Construction Program Director Healthcare Construction Program Director POINTCORE Construction ... POINTCORE Construction is seeking a Healthcare Construction Program Director in the ... cost models. Actively facilitate value management at..

Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..

... and clinical compliance, and case management. Serve as a Humana Military/Humana ... for quality standards, claims accuracy, fraud, and required clinical elements. Perform ... clinical elements. Perform telephonic case..

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 ..