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... in process consulting to support compliance within the Healthcare Services (HCS) ... (HCS) organization. As a HCS Compliance & Risk Management Professional, you ... effectiveness and efficiency of Medicare/Medicaid..
Description The Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
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 ..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities Seeking Senior..
Description The Compliance Nurse 2 reviews utilization management activities ... fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied ... appropriate courses of action. The Compliance Nurse..
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 .....
Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..
Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
Job Information Humana HCS Compliance & Risk Management Quality Audit ... action. Responsibilities As a HCS Compliance & Risk Management Quality Audit ... be responsible for executing the Compliance Oversight..
Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Bethesda Maryland Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, ..
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..
... Information Humana Medicaid Associate Director, Compliance Nursing in Washington District Of ... Columbia Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
... Information Humana Medicaid Associate Director, Compliance Nursing in Bethesda Maryland Description ... Maryland Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Washington District Of Columbia Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE ..
