Audit Manager Healthcare Jobs

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 Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Cincinnati Ohio Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Job Information Humana Director, Behavioral Health Strategy in Cincinnati Ohio Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care for ..

... is looking for an experienced Healthcare Investigator to join its industry ... billing practices. Prepares investigative and audit reports. Begins to influence department's ... areas Bachelor's degree or significant..

Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Cincinnati Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..

... Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical ... in compiling and presenting your audit findings? If you answered YES ... production based environment of clinical..

Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Cincinnati Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..

Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Cincinnati Ohio Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..

Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..

... looking for an experienced Senior Healthcare Investigator to join its industry ... practices. Prepares complex investigative and audit reports. Begins to influence department's ... Qualifications Bachelor's degree or significant..

Description The Risk Management Professional 2 a critical member within Humana's Third Party Risk Management Program (TPRM), a 2nd Line of Defense function, will be responsible for maturing our program by ..

Job Information Humana Medicare Enrollment Representative 2 - Remote in Cincinnati Ohio Description The Enrollment Representative 2 processes applications from members, enrolls them on company platforms, and transmits enrollment to Center ..

Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..

Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Cincinnati Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..

... (CCM) organization is seeking a Manager, Fraud & Waste to join ... join the Provider Payment Integrity-Clinical Audit team working remote anywhere in ... As the Fraud & Waste..

Description The Risk Management Professional 2 a critical member within Humana's Third Party Risk Management Program (TPRM), a 2nd Line of Defense function, will be responsible for maturing our program by ..

Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..

... The Associate Director for ACD Audit , at the director of ... Orders, for ACD Program Integrity Audit; driving to operational excellence, repeatable ... system needs, data needs, provider..

... Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, ... Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2, ... include: Collaborate with the Quality..

Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..

Job Information Humana Manager, Fraud and Waste-Remote US in ... in Cincinnati Ohio Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..

Job Information Humana Bilingual Quality Auditor in Cincinnati Ohio Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..