Healthcare Quality Compliance Jobs in Portland

... Information Humana Medicaid Associate Director, Compliance Nursing in Portland Maine Description ... Maine 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%..

... philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and ... and other members of the healthcare team to interpret, adjust, and ... delivery of patient care in..

... Update as process change for compliance and oversight of appropriate materials ... company training requirements for company, quality, and regulatory compliance. Analyzes course evaluations in order ... 1 or..

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..

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 ..

... in Portland Maine Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) relies ... guidance to ensure..

... in Portland Maine Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician..

... Information Humana Senior Insurance Product Compliance Professional in Portland Maine Description ... Description The Senior Insurance Product Compliance Professional Performs consultation and research ... development. The Senior Insurance Product..

... Summary: The Fresenius Medical Care Healthcare Recruitment registered nurse (RN) is ... responsible for the delivery of quality patient care through the nursing ... The RN collaborates with other..

... (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 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 ..

Job Information Humana Quality Improvement Coordinator in Portland Maine ... in Portland Maine Description The Quality Improvement Coordinator 3 assists in ... assists in administering and monitoring quality improvement and..

Powerback is a new way of delivering recovery, rehabilitation, respiratory, and wellness services to patients across the nation. We deliver an empowered approach to achieving your full potential by providing integrated ..

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..

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..

Job Information Humana Bilingual Quality Auditor in Portland Maine Description ... Portland Maine Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..

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 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..

... ensure the delivery of high quality care to achieve positive clinical ... on assigned shift including ensuring compliance with Genesis policies and procedures, ... transfers and terminations. Why Genesis?Genesis..

... (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..

... 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..