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... Governance is the combination of Compliance processes established and executed that ... 5 years experience with accrediting compliance for medicare advantage programs. Medicare, ... advantage programs. Medicare, Medicaid, and/or..
... 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..
Job ID 21000HHAAvailable Openings 1Position Specific Information Full Time 40 hours per week, supporting up to two clinics.DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer ..
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 ..
... Information Humana Medicaid Associate Director, Compliance Nursing in Albuquerque New Mexico ... Mexico Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description The Senior Compliance Professional will help to reach ... Professional will help to reach compliance program objectives by ensuring compliance with governmental regulations and laws, ... business areas. Responsibilities..
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 ..
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 ..
... which includes fiscal management, standards compliance, clinical practice, staff development, oversight ... as quality improvement and monitoring, regulatory compliance, recruitment and retention of staff ... patient and employee satisfaction...
Job ID 21000FKWAvailable 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 ..
... 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 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 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 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..
Description The Compliance Nurse 2 reviews medical management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse ..
... Information Humana Actuary, Risk and Compliance in Albuquerque New Mexico Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
