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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 ..
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... 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..
... Information Humana Medicaid Associate Director, Compliance Nursing in Springfield Missouri Description ... Missouri Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 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 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..
... 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 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 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 ..
... 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 .....
... Information Humana Actuary, Risk and Compliance in Springfield Missouri Description This ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
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 ..
