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Director Physician Services audit and compliance Duties Manage and deliver internal ... Duties Manage and deliver internal audit and compliance activities to assure they are ... billing and coding audits..
... Information Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania Description ... Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g. CPT) to patient records. The Medical Coding Auditor ..
Job Information Humana Senior IT Compliance Professional- Controls Management (Remote / ... for a talented risk and compliance expert to help build a ... IT leaders to ensure Humana's compliance..
Job Information Humana Senior Compliance Professional - Medicaid in Pittsburgh ... Pittsburgh Pennsylvania Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The..
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..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Pittsburgh Pennsylvania Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ..
Description The Quality Audit Coordinator 2 analyzes and investigates ... investigates quality issues. The Quality Audit Coordinator 2 performs varied activities ... Humana is seeking a Quality Audit Coordinator to..
Description The Claims Quality Audit Representative 3 audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. The Claims Quality Audit Representative 3 performs advanced administrative/operational/customer ..
Job Information Humana Senior Compliance Professional - Disability and Life ... Pittsburgh Pennsylvania Description The Senior Compliance Professional will analyze business requirements, ... in a manner that minimizes compliance risk..
... the role of Director, Internal Audit. In this role, you will ... role, you will lead internal audit initiatives for multiple business segments, ... not have responsibility for Sarbanes-Oxley..
Job Information Humana Senior Compliance Registered Nurse in Pittsburgh Pennsylvania ... Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory ... Case Management and Utilization Management audit team..
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 DRG Validation 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 ..
... directs, plans and evaluates internal audit programs for the organization's information ... and related procedures to ensure compliance with the organization's policies, procedures ... and standards. The Senior IT..
Job Information Humana Quality Assurance Audit Professional 2 in Pittsburgh Pennsylvania ... Description Humana's Marketing Operations Quality Audit team is looking for a ... looking for a Quality Assurance Audit..
Description The Quality Assurance, Clinical Professional 2 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work assignments are varied and ..
Job Information Humana Manager, Compliance - Agent Investigation Unit in ... Pittsburgh Pennsylvania Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, ... with governmental requirements. The Manager,..
Job Information Humana Clinical Auditor Registered Nurse Care Management or Utilization Management in Pittsburgh Pennsylvania Description Humana Healthy Horizons in Ohio is seeking a Utilization and Case Management Clinical Auditors. This ..
Job Information Humana Senior Compliance Professional (PBM & Pharmacy) in ... Pittsburgh Pennsylvania Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The..
Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..
Job Information Humana Senior Compliance Professional, Specialty Compliance in Pittsburgh Pennsylvania Description The ... Pittsburgh Pennsylvania Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with..
Job Information Humana Senior Compliance Professional (Network & Credentialing) in ... Pittsburgh Pennsylvania Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The..
Job Information Humana Bilingual Quality Auditor in Pittsburgh Pennsylvania Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
