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... the region’s largest, most comprehensive healthcare provider with hospitals located in ... and Bowling Green, Kentucky. The healthcare network of choice for thousands ... care you deserve from your..
... Information Humana Medicaid Associate Director, Compliance Nursing in Brentwood Tennessee Description ... Tennessee Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Job Information Humana Bilingual Quality Auditor in Brentwood Tennessee Description ... Brentwood Tennessee Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..
... within a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental expectations, and meets..
Description The Manager, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Manager, Compliance Nursing works within specific guidelines ... and goals. Responsibilities The Manager, Compliance Nursing ensures..
... within a context of regulatory compliance, and work is assisted by ... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... whether services..
... (DM), population health management, contract compliance, quality improvement, and pilot/value-based payment programs. ... and Responsibilities Lead clinical and quality management components of HGB's Integrated ... with effective implementation of..
Description The Principal Quality Leader will lead testing and ... Leader will lead testing and quality collaboration between Business and IT, ... tools and assure adherence to quality standards. Serves..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are ... courses of action. Responsibilities The Quality Compliance Professional 2..
Job Information Humana Quality Improvement Coordinator in Brentwood Tennessee ... in Brentwood Tennessee Description The Quality Improvement Coordinator 3 assists in ... assists in administering and monitoring quality improvement and..
... Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities ... fraud, waste, and abuse. The Compliance Nurse work assignments are varied ... schedule and overtime. Responsibilities The..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... Healthy Horizons Mental Health Parity Compliance..
... in Brentwood Tennessee Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional ... action. Responsibilities As a HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional..
... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... procedures, and training and in compliance with regulations set forth by ... the FMCNA commitment to the..
Description Responsibilities The Compliance Professional 2 has responsibilities for ... on medical record documentation for quality and clinical compliance with contract requirements as outlined ... CPT Codes. KEY ACCOUNTABILITIES 95%..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
... Information Humana Senior Insurance Product Compliance Professional in Brentwood Tennessee Description ... Description The Senior Insurance Product Compliance Professional Performs consultation and research ... development. The Senior Insurance Product..
... in Brentwood Tennessee Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) relies ... guidance to ensure..
