THE LARGEST COLLECTION OF HEALTHCARE JOBS ON EARTH
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... The Associate Director, Patient Assistance Compliance and Quality Assurance will be responsible for ... will be responsible for overseeing Compliance for Patient Services, covering all ... creative solutions to..
... Committee process of materials through Healthcare Compliance (HCC) and Legal Assist in ... persistent follow-ups to drive high quality results Align with HCC, Project ... and lead the guidance,..
Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..
At Bristol Myers Squibb, we are inspired by a single vision - transforming patients' lives through science.In oncology, hematology, immunology and cardiovascular disease - and one of the most diverse and ..
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 ..
... 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,..
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..
... 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,..
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 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 ..
... 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..
... 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..
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%..
... Information Humana Medicaid Associate Director, Compliance Nursing in Jersey City New ... Jersey Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
... 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..
... to ensure the integrity and compliance of regulatory submissions are maintained ... activities h. Ensure the utmost quality of risk management submission content ... management skills to ensure high..
... 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..
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 ..
... 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..
... record content analysis to ensure compliance with requirements of the TRICARE ... of medical records to ensure compliance with TRICARE contractual requirements for ... records to ensure that a..
... 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..
