Compliance Case Manager Jobs in Riverton

Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..

Description The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..

Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is ... auditing for quality and clinical compliance, and case management. Serve as a Humana ... ABA treatment plans for policy..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if a grievance, appeal, or further request is ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that all ..

... with a context of regulatory compliance, and work is assisted by ... meeting departmental expectations, and meets compliance timelines. Supports the assigned work ... on quality management, utilization management,..

Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Riverton Wyoming Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..

Job Information Humana Lead Product Manager - Enrollment (Remote) in Riverton Wyoming Description The Lead Product Manager conceives of, develops, delivers, and manages products for customer use. The Lead Product Manager ..

... seat at the legal and compliance table, for purposes of ensuring ... of streamlining and efficiency identification), case progression, metric reporting to key ... executive stakeholders, communicator to legal,..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..

Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Riverton Wyoming Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, ..

Job Information Humana Senior Cloud Security Engineer (virtual remote) in Riverton Wyoming Description Responsibilities Our Department of Defense Contract requires U.S. citizenship for this position The Remote Senior Cloud Security Engineer ..

Job Information Humana RN-Care Manager, Behavioral Health-RN in an eNLC ... Riverton Wyoming Description The Care Manager, Telephonic Behavioral Health 2, in ... wellbeing of members. The Care Manager, Telephonic..

Description The Care Manager, Telephonic Behavioral Health 2, in ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... Humana is seeking a Care Manager, Telephonic Behavioral..

Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Riverton ... Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible ... auditing for quality and clinical compliance,..

Description The Lead Product Manager conceives of, develops, delivers, and manages products for customer use. The Lead Product Manager works on problems of diverse scope and complexity ranging from moderate to ..

... performing complex tasks related to compliance with accreditation standards across multiple ... performing complex tasks related to compliance with accreditation standards across multiple ... resolving deficiencies that impact plan..