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... in process consulting to support compliance within the Healthcare Services (HCS) organization. As a ... (HCS) organization. As a HCS Compliance & Risk Management Professional, you ... effectiveness and..
... 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 Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
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..
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 ..
... whether services provided by other healthcare professionals are in agreement with ... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... occurs with..
Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..
... Aberdeen South Dakota Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..
... other corporate entities to ensure compliance with established objectives and the ... the realization of quality, economical healthcare services and other related lines ... Has MHA/MBA/MS in hospital administration,..
... occurs 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..
... Information Humana Actuary, Risk and Compliance in Aberdeen South Dakota Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities Seeking Senior..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... monitoring all related behavioral health regulatory..
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 Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..
... Aberdeen South Dakota Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
... 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..
... and analytical approach. Must support compliance related functions under the UMAC ... manages attendance, schedules, assignments, and compliance expectations to ensure adequate coverage ... the business need and maintain..
... occurs 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..
... 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..
