Clinical Compliance Director Jobs in Hammond

... business results. The Regional Associate Director (RAD) is responsible for managing ... activities appropriately within legal and compliance policies. Provides support to commercial ... Understands and complies with all..

Description The Director of Health Services for National ... Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, ... and/or benefit administration determinations. The Director,..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Chicago Illinois Description ... Chicago Illinois Description The Associate Director, Compliance Nursing reviews utilization management activities ... waste, and abuse. The..

Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical Director provides medical interpretation and determinations ... guidelines, CMS requirements, Humana policies, clinical standards, and..

... needs and priorities. Utilizes advanced clinical judgment and critical thinking skills ... Members: Through the use of clinical tools and information/data review, conducts ... and external programs/services. - Applies..

Description The Behavioral Health Medical Director responsible for behavioral health care ... operations. The Behavioral Health Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director..

Description The Medical Director's primary responsibility is the review ... level of care. The Medical Director's work assignments involve moderately complex ... variable factors that rely on clinical experience and..

Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director will provide..

Description The Medical Director actively uses their medical background, ... within a context of regulatory compliance, and work is assisted by ... resources, which may include national clinical guidelines, CMS..

... and Risk Adjustment National Medical Director in Chicago Illinois Description The ... and 3) contribute as a clinical industry representative. As a leader, ... background, business acumen, and industry-standard..

... MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Chicago ... on medical background and industry-standard clinical / coding guidance to ensure ... MD, Stars and Risk Adjustment..

... Responsibilities As a Regional Medical Director you will plan, organize, manage ... marketing events. Develop and maintain compliance with the departmental and physician ... develop and recommend strategies for..

Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..

Job Information Humana VP, Clinical Operations in Chicago Illinois Description ... in Chicago Illinois Description VP, Clinical Operations and Chief Clinical Officer of Kindred at Home, ... vision of the..

Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies ... HPS executive leaders, Trade Relations, Clinical, Analytics, Actuaries, and Operation functions ... the formulary strategies. Responsibilities The Director, Pharmacy..

Description The Medical Director actively uses their medical background, ... within a context of regulatory compliance, and work is assisted by ... resources, which may include national clinical guidelines, CMS..

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Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... within a context of regulatory compliance, and work is assisted by ... resources which may include national clinical..

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 ..

Job Information Humana Director, Care Delivery and EMR/EHR Technology ... in Chicago Illinois Description The Director, Technology Solutions devises an effective ... and the core EMR/EHR. The Director, Technology Solutions..

Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical Director provides medical interpretation and determinations ... guidelines, CMS requirements, Humana policies, clinical standards, and..

... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... patient care while maintaining cost-effective clinical operations in accordance with all ... in accordance with all legal,..

Job Information Humana Director, Informatics in Chicago Illinois Description ... in Chicago Illinois Description The Director, Informatics coordinates with other analytics, ... insights from knowledge SMEs. The Director, Informatics requires..