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... 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 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 Louisiana Medicaid Pharmacy Lead 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, ..
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 This Senior Fraud and Waste Investigator will serve ... monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance ... agencies such as the Medicaid Fraud Control Unit..
Job Information Humana Manager, Fraud and Waste-Remote US in Metairie ... Metairie Louisiana Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
... Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Compliance ... plus Previous experience in utilization..
... 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..
... TX/FL/GA/LA/SC in Metairie Louisiana Description Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. The ... Compliance Nurse 2 reviews utilization..
Job Information Humana Manager, Fraud and Waste-Remote US in New ... Orleans Louisiana Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
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 ..
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,..
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 ..
... 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..
