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... Information Humana Medicaid Associate Director, Compliance Nursing in Portsmouth New Hampshire ... Hampshire 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 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 ..
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 ..
... 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..
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 ..
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 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..
Powerback is a new way of delivering recovery, rehabilitation, respiratory, and wellness services to patients across the nation. We deliver an empowered approach to achieving your full potential by providing integrated ..
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..
... Portsmouth New Hampshire Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
... 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 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..
Job ID 21000GDAAvailable Openings 1 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of ..
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 ..
... Information Humana Actuary, Risk and Compliance in Portsmouth New Hampshire Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
... programs and services of Heritage Healthcare through formal and informal interactions ... with the community. Act in compliance with Heritage Healthcare†s regulatory and professional standards and guidelines. .....
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 ..
... and other members of the healthcare team to interpret, adjust, and ... delivery of patient care in compliance with standards outlined in the ... philosophy. Adheres to the FMCNA..
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 Portsmouth New Hampshire ... Description The Senior Insurance Product Compliance Professional Performs consultation and research ... development. The Senior Insurance Product..
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..
