Healthcare Quality Compliance Jobs

... Information Humana Medicaid Associate Director, Compliance Nursing in Fargo North Dakota ... Dakota Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..

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..

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 Compliance (UM) Letters Coordinator 2 conducts ... Coordinator 2 conducts and summarizes compliance audits. Compliance (UM) Letters Coordinator 2 performs ... - Saturday 9am-6pm CST The Compliance (UM) Letters..

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..

... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... participating in teams focusing on quality management, utilization management, case management, ... Delivery Systems,..

... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental..

... with 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..

... Fargo North Dakota 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 Utilization Management Registered Nurse, RN 2 in Fargo North Dakota Description The Utilization Management Nurse applies a Person-Centered approach, works within specific guidelines and procedures; applies advanced technical ..

... Fargo North Dakota Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) relies ... guidance to ensure..

Description The Compliance (UM) Coordinator 2 conducts and ... Coordinator 2 conducts and summarizes compliance audits. The Compliance (UM) Coordinator 2 performs varied ... on semi-routine assignments. Responsibilities The Compliance..

Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 in Fargo North Dakota Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..

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..

Job Information Humana Quality Improvement Coordinator in Fargo North ... Fargo North Dakota Description The Quality Improvement Coordinator 3 assists in ... assists in administering and monitoring quality improvement and..

... Information Humana Senior Insurance Product Compliance Professional in Fargo North Dakota ... Description The Senior Insurance Product Compliance Professional Performs consultation and research ... development. The Senior Insurance Product..

Job Information Humana Director, Informatics in Fargo North Dakota Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights ..

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..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Fargo North Dakota Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..

... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... experience leading teams focusing on quality management, utilization management, discharge planning ... working with..

Job Information Humana RN-Care Manager, Behavioral Health-RN in an eNLC state required in Fargo North Dakota Description The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates ..

... 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..

... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental expectations, and meets..