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... you. Responsibilities The Senior IT Compliance Professional works with all parts ... information systems procedures are in compliance with industry and corporate standards. ... track and manage Risk and..
... Information Humana Actuary, Risk and Compliance in Billings Montana Description This ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
Job Information Humana Vendor Management Specialist 3 in Billings Montana Description ... Montana Description The Vendor Management Specialist 3 works as liaison between ... and organization. The Vendor Management Specialist..
... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... a thorough investigation to maintain compliance with Humana and governmental requirements ... external partners (Law Enforcement, Legal,..
Description Introduction The 3rd Party Segment Lead will execute and lead a team of risk professionals in conducting cyber and regulatory-driven assessments and oversight of key 3rd Parties across designated business ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
... to promote accurate and complete documentation Recommend and review medical coding ... related education for medical record documentation guidelines Review and respond to ... to diagnosis coding to ensure..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Billings Montana Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
... Humana Lead, IT Risk and Compliance - Business Managed Technology in ... The Lead, IT Risk and Compliance - Business Managed Technology is ... - UDOIT) Governance, Risk and..
Job Information Humana Medicare Appeals and Grievance Medical Director in Billings Montana Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
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 ..
Job Information Humana Supervisor, UM Administration-Remote in Billings Montana Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; ..
Job Information Humana FP&A Lead, Medicaid Market in Billings Montana Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Job Information Humana UM Medical Director - Conviva in Billings Montana Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Description The Senior IT Compliance Professional audits the most complex ... information systems procedures are in compliance with corporate standards. The Senior ... corporate standards. The Senior IT Compliance Professional..
Description Be a part of our Interoperability space - Provide guidance to facilitate interaction with digital services and capabilities that connect people with lifelong well-being. Responsibilities Humana is seeking Product Owners ..
Description The Supervisor, Compliance Nursing reviews utilization management activities ... reviews utilization management activities and documentation to ensure adherence to policies, ... waste, and abuse. The Supervisor, Compliance Nursing works..
Job Information Humana Medical Director - National Medicare Team in Billings Montana Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Job Information Humana Senior Integration Specialist - Cloud in Billings Montana ... Job Posting Title Senior Integration Specialist Job Description Summary The Senior ... and communication between development, security, compliance,..
... timely requirements, prioritization, testing and documentation Develop and maintain key relationships ... support of Healthcare Interoperability and compliance to CMS regulations Develop criteria ... measurement of Healthcare Interoperability and..
Job Information Humana Lead Cloud Advocate in Billings Montana Description Humana Cloud Adoption Services team is looking for a Lead Technology Leadership Professional responsible to deliver new technological solutions coordinating solutions ..
