Audit Manager Healthcare Jobs

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 Tulsa Oklahoma Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..

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 ..

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 Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Tulsa Oklahoma Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..

... (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 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 ..

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 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 ..

... 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..

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

... 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 Behavioral Health Medical Director - Oklahoma Medicaid in Tulsa Oklahoma Description Humana's Oklahoma Medicaid BH Medical Director will oversee our behavioral health (BH) clinical program for Oklahoma Medicaid ..

... 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..

... 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..

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

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

Job Information Humana Communications & Sales Conduct Risk Management Lead-US-Remote in Tulsa Oklahoma Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), ..

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

Job Information Humana Enterprise Risk Management Lead-US-Remote in Tulsa Oklahoma Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..

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