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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 ..
Description The Pharmacy Claims Lead - Overpayment works on problems of diverse scope and complexity ranging from moderate to substantial. The Pharmacy Claims Lead will lead the development and implementation for ..
... Improvement Professional is knowledgeable of regulatory and compliance guidelines specifically as it relates ... accurately on matters such as regulatory guidelines, updates, and the impacts ... related tasks, works..
Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of ... & Analytics to ensure continued compliance through innovative product offerings and ... and..
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 ..
... include meeting Federal and State regulatory sales oversight requirements. The person ... operating standards and to reduce regulatory risk. This person will assist ... duties and works under minimal..
Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of ... moderate to substantial. Responsibilities The Compliance Lead develops and implements compliance policies and..
Job Information Humana Compliance Lead - Remote in Troy ... in Troy Michigan Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of .....
... tasks, and works under minimal supervision. The Lead uses independent judgment ... governance, vendor management, disaster recovery, compliance, and first line risk management ... environment. Coordinates with privacy and..
Description The Compliance Lead ensures compliance with governmental requirements and works ... include: Responsible for effectiveness of compliance program which includes metrics, reporting, ... process improvements and automation to compliance..
... - Career Framework, Market Analysis, Regulatory in Troy Michigan Description The ... of any new pay related Regulatory/Legislative changes; recommend and implement necessary ... necessary program/process changes to ensure..
... to drive operational excellence, advance compliance results, and improve audit readiness. ... design, deliver, and drive internal compliance measures through the implementation of ... state and federal legislative and..
... are aligned with industry and regulatory IT standards and overall IT ... cyber consulting, risk assessments and compliance audits, the testing for possible ... tasks, and works under minimal..
Description The Lead, IT Compliance assesses the most complex new ... systems procedures follow corporate standards, regulatory requirements, and best practice frameworks. ... practice frameworks. The Lead, IT Compliance works..
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 Compliance (UM) Coordinator 3 conducts and ... Coordinator 3 conducts and summarizes compliance audits. The Compliance (UM) Coordinator 3 performs advanced ... monitoring and promoting operational and regulatory..
Description The Compliance Lead (SNP) ensures compliance with governmental requirements. The Compliance Lead works on problems of ... moderate to substantial. Responsibilities The Compliance Lead (SNP) develops and implements .....
