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... Information Humana Medicaid Associate Director, Compliance Nursing in Albany New York ... York Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description The Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
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 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 ..
Description The Compliance Nurse 2 reviews utilization management ... fraud, waste, and abuse. The Compliance Nurse 2 work assignments are ... appropriate courses of action. The Compliance Nurse 2 will..
... Update as process change for compliance and oversight of appropriate materials ... requirements for company, quality, and regulatory compliance. Analyzes course evaluations in order ... 1 or more years..
... Information Humana Senior Insurance Product Compliance Professional in Albany New York ... Description The Senior Insurance Product Compliance Professional Performs consultation and research ... development. The Senior Insurance Product..
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 Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
Job Code 2170181 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly ..
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 ..
... 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..
Title: Healthcare Compliance Analyst Location: Albany, NY - ... Duties Evaluate child/youth's case for compliance to applicable regulations. Clearly communicate ... data and documentation to support compliance findings. Utilize technology..
... Albany New York Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Job ID 21000L6OAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
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 ..
... Information Humana Actuary, Risk and Compliance in Albany New York Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
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..
... our clients through today's ever-changing healthcare landscape. Your day-to-day role as ... New York State and their compliance with the Home and Community ... Duties Evaluate the case for..
... our clients through today's ever-changing healthcare landscape. Your day-to-day role as ... New York State and their compliance with the Home and Community ... Duties: Evaluate the case for..
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..
... be done timely and in compliance with company standard operating procedures ... all local, state and federal regulatory requirements. PRINCIPAL DUTIES AND RESPONSIBILITIES: ... standard operating procedures and in..
