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... Information Humana Medicaid Associate Director, Compliance Nursing in Sandy Utah Description ... Utah 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 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 ..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... monitoring all related behavioral health regulatory..
... whether services provided by other healthcare professionals are in agreement with ... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... occurs with..
... occurs 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..
Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..
... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and policy requirements. Assists physicians ... for the radiology procedures in compliance with FMCNA policies and procedures .....
Job ID 21000MDVAvailable Openings 2PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
... Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities ... fraud, waste, and abuse. The Compliance Nurse work assignments are varied ... schedule and overtime. Responsibilities The..
... Information Humana Actuary, Risk and Compliance in Sandy Utah Description This ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
... procedures, and training and in compliance with regulations set forth by ... through education regarding all ESRD regulatory and legal requirements and the ... systems incorporated into training, including..
Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..
... occurs within a context of regulatory compliance, and work is assisted by ... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... whether..
Job ID 21000JS6Available Openings 1 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of ..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities Seeking Senior..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
... in Sandy Utah Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..
... requirements of any governmental or regulatory body having jurisdiction in the ... quality of patient care Ensure compliance of state requirements and licensure ... medical records management and HIPAA..