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... Information Humana Medicaid Associate Director, Compliance Nursing in San Antonio Texas ... Texas Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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Description The Senior Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Senior Compliance ..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... Healthy Horizons Mental Health Parity Compliance..
Description Responsibilities The Autism Care Demonstration (ACD) Senior Learning Design Professional analyzes content, organizes content, designs solutions, and writes storyboards, scripts, performance support, newsletters and notification letters. Analyzes learning needs and ..
Description Responsibilities This position will maintain the Humana Military ACD website Autism Center of Excellence (CoE); ensuring educational information is current and relevant to training needs in addition to analyzing and ..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
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 ..
... performing complex tasks related to compliance with accreditation standards across multiple ... performing complex tasks related to compliance with accreditation standards across multiple ... resolving deficiencies that impact plan..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
... Information Humana Actuary, Risk and Compliance in San Antonio Texas Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
Description Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. The ... industry as a whole. The Compliance Nurse 2 reviews utilization..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in San Antonio Texas Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for ..
Description The Stars Improvement Coordinator develops, implements, and manages oversight of the company's Medicare/Medicaid Stars Program. Directs all Stars quality improvement programs and initiatives. The Stars Improvement Coordinator performs varied activities ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
... Quadruple Aim construct. Ensure contractual compliance, coordinate and direct the efforts ... of multiple assigned HCO(s). Ensure compliance with contractual requirements, coordinate and ... Processing) Bachelor's degree in Nursing,..
District: International Leadership of Texas School Name: Garland K8 City, State: Garland, TX County: Dallas Region: Region 10 Category: Campus Title: Nurse Assistant Salary: $26,000-$31,000 per year Deadline: Open until filled. ..
Description The Care Management Support Assistant 2 (CMSA2) contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... within a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
