Healthcare Regulatory Compliance Jobs in Cincinnati

... to alternate space *Support the compliance activities of the division(s), including ... of the division(s), including all regulatory compliance, clinical trials, billing, animal care, ... Master’s degree preferred. Degree..

Current UC employees must apply internally via SuccessFactors > http://bit.ly/UCEMPL   The University of Cincinnati is a premier, public, urban research university; ranked as one of America’s top 26 public research universities ..

Internal applicants must apply internally via SuccessFactors > http://bit.ly/UCEMPL   The University of Cincinnati is a premier, public, urban research university; ranked as one of America’s top 26 public research universities by ..

Job ID 21000HEBAvailable Openings 1PURPOSE 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. ..

... 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..

... 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 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 Network Operations Lead maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. The Network Operations Lead ..

... 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 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..

Description The Actuary, Pricing is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new plans ..

Description The Contract Administrator (Compliance Lead) ensures compliance with governmental requirements. The Compliance Lead works on problems of ... substantial. Responsibilities The Contract Administrator (Compliance Lead) will provide strategic guidance..

Description Responsibilities The Your Home Advantage (YHA) Market Clinical Manager (MCM) will lead a team of Advanced Practice Provider (APP) Clinicians (ARNP and PA) responsible for member outreach with In-Home Wellness ..

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

Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..

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..

... relationships with physicians, providers and healthcare systems in order to maintain ... aligned with State contract and regulatory requirements. Ensures compliance with contractual requirements as it ... process improvement..

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 Associate Director, Utilization Management Nursing uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, ..

... occurs 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..

Description Humana's Medicaid Behavioral Health Medical Director will oversee our behavioral health (BH) clinical program for Medicaid plan members. They will collaborate closely with the Chief Medical Officer (CMO) and the ..

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 ..

... Information Humana Actuary, Risk and Compliance in Cincinnati Ohio Description This ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..