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Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
... health. Dedicated to simplifying the healthcare experience and helping people navigate ... and helping people navigate their healthcare journey, Author is leveraging digital ... a new path for the..
... in all phases of the audit process including evaluating control design ... 5 or more years of healthcare revenue cycle management experience may ... with Auditing and monitoring of..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Bethesda Maryland Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..
... 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..
Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..
... 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 The Supervisor, 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 Supervisor, Compliance ..
Job Information Humana Enterprise Risk Management Lead-US-Remote in Bethesda Maryland Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..
Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..
Job Number: R0134245 Healthcare Program Eligibility Reviewer, Mid Key Role: Create efficiency in the consulting profession while supporting healthcare clients at the forefront of Medicaid policy initiatives. Work with a client's ..
What You Will Do: Healthcare Info Analyst II Full Time, 8:00am-4:30pm Baltimore, ... compliance and standards of care. Analyst provides advanced design, development, maintenance, ... tasks to Health Care Information..
... 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 Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
Job Information Humana Senior Risk Management Professional - Third Party Risk Management-Remote, US in Bethesda Maryland Description The Senior Risk Management Professional a critical member within Humana's Third Party Risk Management ..
Job Information Humana Communications & Sales Conduct Risk Management Lead-US-Remote in Bethesda Maryland Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), ..
... packages, case mix analytical packages, audit impact accruals, uncompensated care data, ... experience in HSCRC reimbursement, Maryland Healthcare Commission (MHCC), and HSCRC/Medicare Cost ... degree is required. Specialization in..
... implement and maintain clinical lab audit concepts. The Nurse Auditor 2 ... Auditor 2 will perform clinical audit and validation processes to ensure ... implement and maintain clinical lab..
... site after 5 seconds) Adventist Healthcare seeks to hire an experienced ... experienced Charge Capture & Data Analyst who will be a member ... a Charge Capture & Data..
