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... 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..
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 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 CCM Compliance Professional 2 ensures compliance with governmental and contractual requirements. The CCM Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the ..
... 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 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,..
Company Name: Mariano's Position Type: Employee FLSA Status: Non-Exempt POSITION SUMMARY: Provide professional pharmacy services, including filling prescriptions, counseling patients and supervising pharmacy technicians. Assure that all services comply with professional ..
... BCG delivers solutions through leading-edge management consulting along with technology and ... diligence, product development studies, change management plans, and the evaluation of ... aligned. Principals provide the project..
... 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..
Project Manager - Healthcare Construction - Chicago, IL Our ... top general contractors Hands off management approach Great relationships with subcontractors ... of experience in Construction Project Management Degree in..
Job Information Humana Manager, Fraud and Waste-Remote US in Chicago ... Chicago Illinois Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
Job Information Humana Compliance Nurse 2 - IL Medicaid - RN Remote in Chicago Illinois Description The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, ..
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 ..
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 &..
Description The Manager, 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 Manager, Compliance ..
Job Information Humana Manager, Fraud and Waste-Remote US in Peoria ... Peoria Illinois Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
