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... Information Humana Medicaid Associate Director, Compliance Nursing in Newport Rhode Island ... Island 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 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 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 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 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 ..
... nation's leading providers of post-acute healthcare services from short-term to long-term ... through the delivery of high-quality healthcare and everyday compassion!We Care Deeply ... and compassion to patients/residents. *Ensure..
Job Description Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we're ..
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 Senior Insurance Product Compliance Professional in Newport Rhode Island ... Description The Senior Insurance Product Compliance Professional Performs consultation and research ... development. The Senior Insurance Product..
... 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 Actuary, Risk and Compliance in Newport Rhode Island Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
... Newport Rhode Island 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 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 ..
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..
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..
... the nations' leading provider of healthcare services from short-term to long-term ... through the delivery of high-quality healthcare and everyday compassion!We Care Deeply ... and records maintenance to ensure..