Audit Manager Healthcare Jobs in Tampa

Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..

Job Information Humana Associate Director Utilization Management in Tampa Florida Description Come join our team. We are looking for an Associate Director, Utilization Management to utilize clinical nursing skills to support ..

Description Responsibilities Participates in all activities associated with delegated credentialing and recredentialing of providers in the TRICARE East Region, and Humana Government Business subsidiaries' networks. Monitors delegated organizations in processing provider ..

Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..

... Medical Coding Auditors Assists the Audit Manager with data analysis, team management, ... guidelines Prepares written summaries of audit findings Presents verbal audit feedback and provides education upon .....

Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..

Description The Senior Wellness Program Professional responsible for educating and motivating clients/employers to participate in the wellness program. The Senior Wellness Program Professional work assignments involve moderately complex to complex issues ..

Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..

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

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 ..

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 ..

Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..

Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..

... The Associate Director for ACD Audit , at the director of ... Orders, for ACD Program Integrity Audit; driving to operational excellence, repeatable ... system needs, data needs, provider..

Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..

Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..

... 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..

Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..

Description The Compliance Manager ensures compliance with governmental requirements. ... with governmental requirements. The Compliance Manager works on problems of diverse ... to substantial. Responsibilities The Compliance Manager develops and..

Description The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse ..

Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..

... Medical Coding Auditors Assists the Audit Manager with data analysis, team management, ... guidelines Prepares written summaries of audit findings Presents verbal audit feedback and provides education upon .....

... (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..