Healthcare Regulatory Compliance Jobs

... Information Humana Medicaid Associate Director, Compliance Nursing in Fargo North Dakota ... Dakota 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 Senior Compliance Professional will help to reach ... Professional will help to reach compliance program objectives by ensuring compliance with governmental regulations and laws, ... business areas. Responsibilities..

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..

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 ..

... 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..

... including headcount planning to ensure compliance with state requirements o Perform ... development and administration o Ensure compliance with all state regulatory financial reporting and overall state ... the..

... 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..

... Information Humana Actuary, Risk and Compliance in Fargo North Dakota Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..

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 ..

... Fargo North Dakota Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..

Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 in Fargo North Dakota Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..

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

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..

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

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 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..

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 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..

... 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..

... 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..

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

... occurs with 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..