Audit Manager Healthcare Jobs in Lancaster

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 Lancaster South Carolina Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..

... 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..

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

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 Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Lancaster South Carolina Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns ..

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 ..

... Medical Coding Auditors Assists the Audit Manager with data analysis, team management, ... guidelines Prepares written summaries of audit findings Presents verbal audit feedback and provides education upon .....

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

Job Information Humana Process Improvement Lead South Carolina Medicaid (Utilization and Case Management) in Lancaster South Carolina Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes ..

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 ... Lancaster South Carolina Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..

... 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-Remote/Virtual in US in Lancaster South Carolina Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural ..

... (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..

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

... 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..

... 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..

... 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..

... Medical Coding Auditors Assists the Audit Manager with data analysis, team management, ... guidelines Prepares written summaries of audit findings Presents verbal audit feedback and provides education upon .....

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 ..

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

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