Healthcare Quality Compliance Jobs

... HOS Able to articulate relevant healthcare quality standards and provide educational support ... and target providers with low quality scores Determine causation of low ... low scores, i.e., documentation,..

... Information Humana Medicaid Associate Director, Compliance Nursing in Tulsa Oklahoma Description ... Oklahoma 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..

DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own. Connect with your goals and change ..

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

... services, including utilization management (UM), quality improvement, and value-based payment programs. ... Responsibilities Lead major clinical and quality management components of Humana's BH ... with effective implementation of the..

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..

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

Details Department: Stepdown Intermediate Care Schedule: 36 hours weekly, full time day shift Hospital: Ascension St John Medical Center Location: Tulsa, Ok Benefits Paid time off (PTO)Various health insurance options & ..

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..

DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own. Connect with your goals and change ..

Description The Quality Management Director provides strategic leadership ... leadership for Humana's Oklahoma Medicaid Quality Program, in alignment with organizational ... Program, in alignment with organizational quality and population health..

... 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..

... Care, you will ensure that quality patient care is delivered while ... part of the future of healthcare, apply today. PRINCIPAL RESPONSIBILITIES AND ... including costs, processes, staffing, and..

... procedures, and training and in compliance with regulations set forth by ... Supportsthe FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) .....

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

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%..

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

... performance, policies and procedures, ensuring compliance with legal, organizational, and home ... care delivery model by assessing quality and efficiency and leading appropriate ... progressive leadership experience in the..

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

Job Information Humana Quality Improvement Coordinator in Tulsa Oklahoma ... in Tulsa Oklahoma 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..