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27

Healthcare Quality Compliance Jobs





Job info
 
Company
**********
Location
Portland, OR
Posted Date
Apr 22, 2020
Info Source
Employer  - Full-Time  90  

u003cpu003eTeam Lead, QMHP (Full-Time PM/Tue-Sat) - Behavioral Health 209u003c/pu003enu003cpu003eFounded in 1965, Telecare is a rapidly growing mental health care company dedicated to making a difference for our clients, the community, and ..

 
Company
**********
Location
Portland, OR
Posted Date
Aug 20, 2020
Info Source
Employer  - Full-Time  90  

u003cpu003eFounded in 1965, Telecare is a rapidly growing mental health care company dedicated to making a difference for our clients, the community, and our employees. We offer an array of mental ..

 
Company
**********
Location
Portland, OR
Posted Date
Aug 25, 2020
Info Source
Employer  - Full-Time  90  

u003cpu003eu003cstrongu003eu003cspanu003eu0026nbsp;u003c/spanu003eu003c/strongu003eu003c/pu003enu003cpu003eFounded in 1965, Telecare is a rapidly growing mental health care company dedicated to making a difference for our clients, the community, and our employees. We offer an array of mental ..

 
Company
**********
Location
Portland, OR
Posted Date
Nov 20, 2020
Info Source
Employer  - Full-Time  90  

... records, logs, and systems in compliance with HIPAA regulationsu003cbr /u003eu0026bull; Implements ... that the Program is in compliance with all related state, federal, ... Establishes and maintains a comprehensive..

 
Company
Humana Inc.
Location
Portland, ME
Posted Date
May 16, 2021
Info Source
Employer  - Full-Time  90  

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..

 
Company
Humana Inc.
Location
Portland, ME
Posted Date
May 12, 2021
Info Source
Employer  - Full-Time  90  

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 ..

 
Company
**********
Location
Portland, ME
Posted Date
Jul 27, 2021
Info Source
Employer  - Full-Time  90  

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..

 
Company
**********
Location
Portland, ME
Posted Date
Jun 29, 2021
Info Source
Employer  - Full-Time  90  

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 ..

 
Company
**********
Location
Portland, ME
Posted Date
Jun 26, 2023
Info Source
Employer  - Full-Time  90  

... 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..

 
Company
**********
Location
Portland, OR
Posted Date
Apr 21, 2021
Info Source
Employer  - Full-Time  90  

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 ..

 
Company
**********
Location
Portland, ME
Posted Date
Aug 05, 2021
Info Source
Employer  - Full-Time  90  

... 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..

 
Company
Humana Inc.
Location
Portland, ME
Posted Date
Oct 06, 2021
Info Source
Employer  - Full-Time  90  

... 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..

 
Company
Humana Inc.
Location
Portland, ME
Posted Date
Aug 27, 2021
Info Source
Employer  - Full-Time  90  

... 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..

 
Company
**********
Location
Portland, ME
Posted Date
Mar 22, 2021
Info Source
Employer  - Full-Time  90  

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

 
Company
Humana Inc.
Location
Portland, ME
Posted Date
Sep 24, 2021
Info Source
Employer  - Full-Time  90  

... 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..

 
Company
**********
Location
Portland, OR
Posted Date
Jul 04, 2021
Info Source
Employer  - Full-Time  90  

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 ..

 
Company
Humana Inc.
Location
Portland, ME
Posted Date
Sep 20, 2021
Info Source
Employer  - Full-Time  90  

... 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..

 
Company
**********
Location
Portland, ME
Posted Date
Apr 09, 2021
Info Source
Employer  - Full-Time  90  

Description The Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..

 
Company
**********
Location
Portland, ME
Posted Date
May 13, 2021
Info Source
Employer  - Full-Time  90  

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 ..

 
Company
**********
Location
Portland, ME
Posted Date
Jun 11, 2021
Info Source
Employer  - Full-Time  90  

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%..

 
Company
**********
Location
Portland, ME
Posted Date
Sep 15, 2021
Info Source
Employer  - Full-Time  90  

... 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..

 
Company
**********
Location
Portland, ME
Posted Date
Jun 26, 2023
Info Source
Employer  - Part-Time    90  

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 ..

 
Company
**********
Location
Portland, ME
Posted Date
Apr 11, 2021
Info Source
Employer  - Full-Time  90  

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 ..

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