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Description The Senior Policy Governance Professional policy Governance is the combination of Compliance processes established and executed that are reflected in the organization's structure and how it is managed and led ..
Description Humana is seeking a Genetic Counselor to assist in the detecting and investigation of potential fraud and provide clinical guidance to the Special Investigators handling the cases. This is an ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Cincinnati Ohio Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese and ..
Description Mail Operations Pharmacy Supervisor works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in ..
Job Information Humana Senior Nursing Educator - Remote OH, IN, KY in Cincinnati Ohio Description The Senior Nursing Educator plans, directs, coordinates, evaluates, develops, and/or delivers training and education programs for ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Head of Clinical Trial Statistics and CTU Associate Director (Oxford Clinical Trials Research Unit, OCTRU) University of Oxford - Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences Location: Oxford Salary: £59,450 ..
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 ..
... knowledge regarding community and regional healthcare market and industry issues which ... systems within designated area. Oversees Privacy and Security compliance according to ... concentration in Business, Finance or..
... limited to, health insurance, data privacy/security/use, artificial intelligence, primary care, clinical ... 5 or more years of healthcare policy experience including a track ... research, and resource development supporting..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Cincinnati Ohio Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..
PURPOSE AND SCOPE: Directs, administers and controls the day to day operations and activities of dialysis facilities and programs in an assigned area ensuring compliance with established company and regulatory guidelines ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
... Qualifications Bachelor's degree in nursing, healthcare, or related field Prior experience ... 3 years' experience working on healthcare quality and performance measure improvement ... their home. We are a..
Job Information Humana Senior Process Improvement Professional - Remote OH, IN, KY in Cincinnati Ohio Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and ..
Description The Care Manager, Telephonic Nurse 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 and ..
Job Information Humana EPSDT Maternal Child Health Professional (Medicaid) - Remote Ohio in Cincinnati Ohio Description The Senior Quality Compliance Professional works with physicians/physician groups to ensure highest accountability of compliance ..
Description The Care Management Support Assistant 3 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..
