Audit Manager Healthcare Jobs in Maine

Job Information Humana Medicaid Associate Director, Compliance Nursing in Portland Maine Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

... review, provider record updates, and audit preparation as defined by the ... medical records. Print and prepare audit folders. Update the web application ... Qualifications 2 plus years of..

... (CCM) organization is seeking a Manager, Fraud & Waste to join ... join the Provider Payment Integrity-Clinical Audit team working remote anywhere in ... As the Fraud & Waste..

Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Portland Maine Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..

Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..

Qualifications nn n Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.nnBasic Requirements:nntUnited States ..

Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..

Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Portland Maine Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..

Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..

Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Portland Maine Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..

Job Information Humana Enterprise Risk Management Lead-US-Remote in Portland Maine Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..

Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Portland Maine Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..

Job Information Humana Manager, Fraud and Waste-Remote US in ... in Portland Maine Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..

Job Information Humana Bilingual Quality Auditor in Portland Maine Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..

Description The Risk Management Professional 2 a critical member within Humana's Third Party Risk Management Program (TPRM), a 2nd Line of Defense function, will be responsible for maturing our program by ..

... Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, ... Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2, ... include: Collaborate with the Quality..

Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..

Job Information Humana Communications & Sales Conduct Risk Management Lead-US-Remote in Portland Maine Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), ..

... looking for an experienced Senior Healthcare Investigator to join its industry ... practices. Prepares complex investigative and audit reports. Begins to influence department's ... Qualifications Bachelor's degree or significant..

... is looking for an experienced Healthcare Investigator to join its industry ... billing practices. Prepares investigative and audit reports. Begins to influence department's ... areas Bachelor's degree or significant..

Description The Risk Management Professional 2 a critical member within Humana's Third Party Risk Management Program (TPRM), a 2nd Line of Defense function, will be responsible for maturing our program by ..

... Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical ... in compiling and presenting your audit findings? If you answered YES ... production based environment of clinical..

Job Information Humana Director, Behavioral Health Strategy in Portland Maine Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care for ..