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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 Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. The ... Compliance Nurse 2 reviews utilization management activities and documentation to..
... Qualifications 3 plus years of healthcare fraud investigation experience 2 plus years ... knowledge and experience Experience in healthcare or in a managed care ... raw data and recommendations..
... The Compliance Nurse reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Compliance ... plus Previous experience in utilization..
... and clinical compliance, and case management. Serve as a Humana Military/Humana ... for quality standards, claims accuracy, fraud, and required clinical elements. Perform ... clinical elements. Perform telephonic case..
... laws and programmatic requirements, including fraud, waste, and abuse; make decisions ... from across the Medicaid and healthcare industry Effectively support the growth ... Qualifications Bachelor's degree in Business,..
Description Humana's Claims Cost Management (CCM) organization is seeking a ... organization is seeking a Manager, Fraud & Waste to join the ... in the US. As the Fraud &..
Company Name: Kroger Stores Position Type: Employee FLSA Status: Non-Exempt POSITION SUMMARY: Assist the pharmacist in reaching sales and profit goals established for the department and monitor all established quality assurance ..
Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
... and prepare reports for senior management as needed. Decision Making Ability ... demonstrate effective negotiation and conflict management skills and a cooperative team ... of leadership experience in compliance..
... TX/FL/GA/LA/SC in Atlanta Georgia Description Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. The ... Compliance Nurse 2 reviews utilization..
... Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Compliance ... carriers Previous experience in utilization..
Job Information Humana Manager, Fraud and Waste-Remote US in Atlanta ... Atlanta Georgia Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
Company Name: Kroger Stores Position Type: Employee FLSA Status: Non-Exempt POSITION SUMMARY: Provide exceptional customer service in a safe and clean environment to ensure the customer's return visit. This is accomplished ..
... Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Supervisor, ... solve basic problems; collaborates with..
Description The Manager, 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 Manager, Compliance ..
Description The Manager, Fraud and Waste, Genetic Counseling provides ... and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works ... and goals. Responsibilities The Manager, Fraud and Waste,..
Description The CCM Compliance Professional 2 ensures compliance with governmental and contractual requirements. The CCM Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the ..
Job Information Humana Manager of Fraud and Abuse Data Analytics in ... Description Responsibilities The Manager of Fraud and Abuse Data Analytics will ... for the supervision of the Fraud..
