THE LARGEST COLLECTION OF HEALTHCARE JOBS ON EARTH
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... others to accomplish common goals Healthcare industry experience preferred COMPANY OVERVIEW ... between their clients’ internal claim management systems and external cost-containment services. ... number of cost-containment services including..
Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a few powerful teams dedicated to reducing waste and abuse in the health care industry and its impacts on Humana. These teams ..
Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
Description The Payment Integrity Professional 2 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 ..
... Officer, you will: Provide strategic management oversight in implementing, directing, and ... Alliance’s Compliance Program Provide strategic management oversight in implementing, directing, and ... include the seven elements, HIPAA,..
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,..
Job Information Humana Manager, Fraud and Waste-Remote US in Fresno ... Fresno California Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
... customer experience, continuous improvement, change management, data integrity and process-level measurements. ... 10% Working with ACD Care Management operational leaders, lead development of ... objectives. Required Qualifications Experience in..
... 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..
Job Information Humana Manager, Fraud and Waste-Remote US in Torrance ... Torrance California Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
... Working as the liaison to management to ensure regulatory compliance with ... or misconduct, including health care fraud, waste, and abuse Implementing effective ... in the aforementioned areas of..
Job Information Humana Manager, Fraud and Waste-Remote US in Los ... Angeles California Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
... 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..
... position with responsibility for utilization management and clinical decision-making as outlined ... clinical information in various medical management systems. The associate understands department, ... limited to: 70% Performing utilization..
... Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Associate ... and quality performance and staffing..
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 ..
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 &..
... including strong contracts/agreements development and management experience, compliance, legal memoranda, business ... hospital operations, medical staff, risk management, regulatory requirements, policy, advocacy, partnership ... ventures, regulatory matters, employment matters,..
Job Information Humana Manager, Fraud and Waste-Remote US in Campbell ... Campbell California Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
