Compliance Monitoring Systems Jobs

Description The Workforce Management Professional 2 applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, ..

Job Information Humana Senior Compliance Professional-Remote/Virtual in US in Lima ... Lima Ohio Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The..

... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... procedures, and training and in compliance with regulations set forth by ... where appropriate - Online Clearance..

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..

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

Job Information Humana Care Manager, Registered Nurse, RN - Maternity, L&D, Mother Baby in Lima Ohio Description The Field Care Manager assesses and evaluates member's needs and requirements to achieve and/or ..

Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of ..

... to drive operational excellence, advance compliance results, and improve audit readiness. ... Design, deliver, and drive internal compliance measures through the implementation of ... across multiple teams to improve..

Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..

Job Information Humana Senior Market Data Professional - Remote in Lima Ohio Description The Senior Market Data Professional provides support to assigned health plan and/or specialty companies relative to Medicare, Medicaid, ..

Job Information Humana Quality Improvement Coordinator in Lima Ohio Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The ..

Description The Supply Chain Professional 2 reports through Humana's Pharmacy Supply Chain and performs DSCSA (Drug Supply Chain Security Act) compliance related tasks in support of Humana's Pharmacy inventory receiving operations. ..

Job Information Humana Senior Value Based Programs Professional - Remote in Lima Ohio Description The National Delegation Oversight and Support (NDOS) Senior Value-Based Programs Professional supports successful value-based provider relationships with ..

Job Information Humana Learning Facilitation Professional 2- Remote in US in Lima Ohio Description The Learning Facilitation Professional 2 conducts or facilitates training courses for organization employees or external audiences. The ..

Job Information Humana Senior Learning Facilitation Professional-Remote in US in Lima Ohio Description The Senior Learning Facilitation Professional will focus on integration and implementation of training solutions for both internal and ..

... and value, while also managing compliance with network requirements, including network ... proactively identify network issues, ensure compliance with Louisiana Department of Health ... commitments and requirements to ensure..

... manage the daily cloud based systems utilizing AWS, Azure, and Google ... and security of cloud based systems. The Engineer is an expert ... with high performing and scaling..

... reactive performance tuning of storage systems, support implementation of storage software ... development, testing, and deployment of systems and upgrades to existing systems. Understands department, segment, and organizational .....

... cost avoidance and claims processing systems capable of paying claims in ... Develop and implement claims processing systems capable of paying claims in ... Work with internal resources and..

Description The Senior Risk Management Professional identifies, analyzes, and works to mitigate potential sources of risk. The Senior Risk Management Professional work assignments involve moderately complex to complex issues where the ..

... towards desired outcomes by continuously monitoring care through use of assessment, ... community resources Coordinates services, and monitoring and evaluating the care coordination ... Teams, Excel, PowerPoint, Outlook and..

Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Lima Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..

Job Information Humana Network Optimization Lead (OH Medicaid) - Remote, Ohio in Lima Ohio Description The Network Optimization Lead, Ohio Medicaid, is responsible for driving network optimization and value, while also ..