THE LARGEST COLLECTION OF HEALTHCARE JOBS ON EARTH
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... monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance ... agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate ... and independently refer suspected member..
... managed care and Pharmacy Benefit Management (PBM) to develop and implement ... scenarios Recommend quality and resource management solutions to reduce waste and ... to identify pharmacy and prescription..
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,..
... 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 Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse ..
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 &..
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 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 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..
... 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 ..
Job Information Humana Manager, Fraud and Waste-Remote US in Tulsa ... Tulsa Oklahoma Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
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 ..
... 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..
