Healthcare Quality Compliance Jobs in South Dakota

... Information Humana Medicaid Associate Director, Compliance Nursing in Aberdeen South 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%..

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

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 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 ..

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

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

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 ..

... other corporate entities to ensure compliance with established objectives and the ... objectives and the realization of quality, economical healthcare services and other related lines ... Has MHA/MBA/MS in..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

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..

... 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..

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

... 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 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..

... 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 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..

... 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..

... 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..

... (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..