THE LARGEST COLLECTION OF HEALTHCARE JOBS ON EARTH
Supports PDF, DOC, DOCX, TXT, XLS, WPD, HTM, HTML files up to 5 MB
Description The Quality Assurance, Clinical Professional 2 consults ... to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work ... courses of action. Responsibilities The..
Sign In or Sign Up in seconds to view this job on HealthcareCrossing.
Description The Senior Quality Assurance, Clinical Professional requires being ... to ensure high accountability of compliance and quality and will work assignments involving ... Categories) coding documentation guidelines and compliance..
Description Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional ... to ensure high accountability of compliance and quality and claims are being reviewed ... implements programs to establish high..
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 and ..
... Information Humana Medicaid Associate Director, Compliance Nursing in Green Bay Wisconsin ... Wisconsin Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 ..
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..
... within a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental expectations, and meets..
... on medical record documentation for quality and clinical compliance with contract requirements as outlined ... for this position . 75% Quality Monitoring Audits. Review and assess ... ensure all..
... Member Plan (EFMP), auditing for quality and clinical compliance, and case management. Serve as ... ABA treatment plans for policy compliance. Assist with analysis of necessary ... Review outcome..
... performing complex tasks related to compliance with accreditation standards across multiple ... performing complex tasks related to compliance with accreditation standards across multiple ... the development and implementation of..
Description The Principal Quality Leader will lead testing and ... Leader will lead testing and quality collaboration between Business and IT, ... tools and assure adherence to quality standards. Serves..
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 Responsibilities The Compliance Professional 2 has responsibilities for ... on medical record documentation for quality and clinical compliance with contract requirements as outlined ... CPT Codes. KEY ACCOUNTABILITIES 95%..
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 The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
... business reviews in accordance with compliance requirements advise Commercial Product of ... recommend opportunities to optimize vendor quality Facilitate the measurement of success ... and/or service level oversight including..
... 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..
... physicians, physician groups, and integrated healthcare delivery systems throughout the country. ... delivery systems throughout the country. Healthcare isn't just about health anymore. ... of our members, and the..
... is committed to providing personalized, high-quality primary care combined with an ... based care provider focused on quality of care for the patients ... Nurse, MA, Behavioral health specialist,..
... is committed to providing personalized, high-quality primary care combined with an ... based care provider focused on quality of care for the patients ... nurses, MAs, behavioral health specialists,..
... Develop and monitor performance and quality of initiatives, providing insight and ... needs, data needs, provider audit compliance etc. 20 % Develop deep ... lead development of meaningful QIPs..
