Healthcare Compliance Manager Jobs in Pittsburgh

Description The Senior Product Manager - Fully Insured supports strategy ... business. Responsibilities The Senior Product Manager supports all phases of the ... desired outcomes. The Senior Product Manager will..

... Information Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania Description ... Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..

Description The Lead Product Manager for Specialty products leads all ... Position Overview The Lead Product Manager Leads all phases of the ... Key Responsibilities The Lead Product Manager works..

Job Information Humana Manager of Fraud and Abuse Data ... Pittsburgh Pennsylvania Description Responsibilities The Manager of Fraud and Abuse Data ... TRICARE Policy Manuals and ensures compliance with applicable..

Healthcare Superintendent - Pittsburgh The Healthcare Superintendent leads, directs and coordinates ... and/or Turner trade labor on healthcare projects. The Superintendent is responsible ... as required and ensuring subcontractor compliance..

... Humana Automated Dispensing System (ADS) Compliance Technician in Pittsburgh Pennsylvania Description ... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... and promoting operational and regulatory..

... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... in accordance with all legal, compliance, and regulatory requirements and programs. ... all requirements of the FMCNA..

Job Information Humana Lead Product Manager - Ancillary Products in Pittsburgh ... Pennsylvania Description The Lead Product Manager Leads all phases of the ... needed. Responsibilities The Lead Product Manager..

... Humana RN Telephonic Transplant Care Manager-WAH in Pittsburgh Pennsylvania Description The ... Pittsburgh Pennsylvania Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care..

Description The Manager, Compliance Nursing reviews utilization management activities ... fraud, waste, and abuse. The Manager, Compliance Nursing works within specific guidelines ... schedules and goals. Responsibilities The Manager, Compliance..

Job Information Humana Lead Product Manager - Group Dental, Vision and ... Pennsylvania Description The Lead Product Manager Leads all phases of the ... needed. Responsibilities The Lead Product Manager..

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..

Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Pittsburgh Pennsylvania Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..

... leader. If you haven't considered Healthcare before, read on as we ... as we think you should. Healthcare Experience is NOT required. For ... year after year. As a..

Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Pittsburgh ... Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible ... auditing for quality and clinical compliance,..

Job Information Humana HCS Compliance & Risk Management Quality Audit ... action. Responsibilities As a HCS Compliance & Risk Management Quality Audit ... be responsible for executing the Compliance Oversight..

Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..

Description The Bilingual Manager, Learning Facilitation , plans, coordinates, ... Grievances and Appeals Learning Facilitation Manager Oversee a team of instructors ... Update as process change for compliance and oversight..

Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..

Job Description : JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate resource utilization, identification of opportunities ..

Job Information Humana Manager, Credentialing in Pittsburgh Pennsylvania Description ... Pittsburgh Pennsylvania Description Responsibilities The Manager, Certifications Operations reviews the applicant's ... and recommends changes that assure compliance with contract..

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 ..

... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... in accordance with all legal, compliance, and regulatory requirements and programs. ... all requirements of the FMCNA..