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Description The Compliance Lead (Medicaid Contract Administrator) ensures ... Lead (Medicaid Contract Administrator) ensures compliance with governmental requirements, works on ... from moderate to substantial. The Compliance Lead (Medicaid Contract..
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 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..
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..
... Lancaster South Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Job Information Humana Compliance Nurse - Conviva - Remote, ... in Lancaster South Carolina Description Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as..
... Information Humana Senior Insurance Product Compliance Professional in Lancaster South Carolina ... Description The Senior Insurance Product Compliance Professional Performs consultation and research ... development. The Senior Insurance Product..
Description The Compliance Nurse 2 reviews utilization management ... fraud, waste, and abuse. The Compliance Nurse 2 work assignments are ... appropriate courses of action. The Compliance Nurse 2 will..
... environment for all. Responsibilities The Compliance Professional 2 develops and implements ... Professional 2 develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that .....
Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
... Update as process change for compliance and oversight of appropriate materials ... requirements for company, quality, and regulatory compliance. Analyzes course evaluations in order ... 1 or more years..
... Information Humana Medicaid Associate Director, Compliance Nursing in Lancaster South Carolina ... Carolina Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Job Information Humana Compliance Lead - Illinois Medicaid in ... Lancaster South Carolina Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of .....
... Information Humana Actuary, Risk and Compliance in Lancaster South Carolina Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
Description The Senior Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Senior 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 ..
Job ID 21000IJPAvailable Openings 1Position Specific Information $1,000 Sign-on Bonus with no dialysis experience $1,500 Sign-on Bonus with dialysis experiencePURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service ..
Description Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. The ... industry as a whole. The Compliance Nurse 2 reviews utilization..
... 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..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
