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Description The RN, 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 RN ..
Clinical Coding We are a fast-growing tech company that provides a SaaS-based healthcare analytics platform for medical records analysis and targeted solutions for HEDIS® Hybrid, Medicare and Exchange Risk Adjustment and ..
Description The Manager, Risk Adjustment oversees coding educators ... and Medicaid Services (CMS). The Manager, Risk Adjustment works within specific ... schedules and goals. Responsibilities The Manager, Risk Adjustment oversees..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires ..
Description CarePlus is seeking a Clinical Business Lead who will lead teams of nurses and behavior health professionals responsible for Care Management and Utilization Management. The Clinical Business Lead works on ..
Job Information Humana Manager, Fraud and Waste-Remote US in ... Saint Augustine Florida Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Description The Associate Director, Full Stack Engineering Performs software engineering activities in all layers of the stack, from setting up the database to programming in the back-end and the appearance at ..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care ..
Job Information Humana Clinical Vendor Management Lead - Remote, FL in Palm Coast Florida Description The Clinical Vendor Management Lead works as clinical liaison between vendors and organization. The Clinical Vendor ..
Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Description Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
