Healthcare Fraud Management Jobs in North Carolina

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 ..

... 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..

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 ..

... 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..

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 ..

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

... 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..

Job Information Humana Manager, Fraud and Waste-Remote US in Wilmington ... North Carolina 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 Raleigh ... North Carolina 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 Asheville ... North Carolina Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..

Job Information Humana Manager of Fraud and Abuse Data Analytics in ... Description Responsibilities The Manager of Fraud and Abuse Data Analytics will ... for the supervision of the Fraud..

Job Information Humana Manager, Fraud and Waste-Remote US in Bakersville ... North Carolina 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 ... carriers Previous experience in utilization..

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

Description The Assistant General Counsel provides a full range of legal advice and services. The Assistant General Counsel provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced ..

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 &..

Healthcare Project Manager - Top 100 ... 100 ENR GC specializing in healthcare, life-science and higher education work. ... various commercial markets, such as healthcare, higher education and life-sciences/biotech 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 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,..

... Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Compliance ... carriers Previous experience in utilization..

... 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..