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... customers Thought Leaders (TL) and Healthcare Providers (HCP) within assigned geography. ... questions, ensuring medical accuracy and compliance with local procedures, company ethical ... Actively assess the medical and..
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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..
... research, competitive analysis and product compliance requirements. Perform data and research ... guidance for marketing materials and regulatory materials to ensure content is ... senior-focused health care or Humana..
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 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 ..
... 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..
... Information Humana Medicaid Associate Director, Compliance Nursing in San Juan Puerto ... Rico Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
