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Description The Senior Policy Governance Professional policy Governance is the combination ... Governance is the combination of Compliance processes established and executed that ... goals. The Senior Policy Governance Professional..
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Description The Senior Risk Management Professional identifies and analyzes potential sources ... risk. The Senior Risk Management Professional work assignments involve moderately complex ... Responsibilities The Senior Risk Management Professional..
Description Responsibilities The Autism Care Demonstration (ACD) Senior Learning Design Professional analyzes content, organizes content, designs solutions, and writes storyboards, scripts, performance support, newsletters and notification letters. Analyzes learning needs and ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Senior Risk Management Professional a critical member within Humana's ... a successful Senior Risk Management Professional candidate, we need you to ... practices to drive our vendor compliance..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex ... variable factors. Responsibilities Seeking..
Description The Senior Health Information Management Professional manages the process of Prescription Drug Event (PDE) error resolution, which includes partnering with Humana Pharmacy Solutions business areas and PDE stakeholders for process ..
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..
Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance..
... The Senior Health Information Management Professional ensures data integrity for claims ... The Senior Health Information Management Professional work assignments involve moderately complex ... The Senior Health Information Management..
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 ..
... Information Humana Medicaid Associate Director, Compliance Nursing in Anchorage Alaska Description ... Alaska Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description The Quality Compliance Professional 2 completes annual quality reviews and ... reviews and research. The Quality Compliance Professional 2 work assignments are varied and ... of action. Responsibilities The..
... in accordance with standards of professional nursing practice, utilizing the framework ... practice, utilizing the framework for professional nursing practice and development. Is ... of care. Provides care in..
Description Responsibilities This position will maintain the Humana Military ACD website Autism Center of Excellence (CoE); ensuring educational information is current and relevant to training needs in addition to analyzing and ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
