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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 will be responsible for managing ... Responsibilities The Senior Risk Management Professional will be dedicated to supporting ... responsible for developing a vendor compliance..
... Information Humana Medicaid Associate Director, Compliance Nursing in Charlotte North Carolina ... Carolina Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 ..
... Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses ... Care Manager, Telephonic Behavioral Health 2 work assignments are varied and ... Care Manager, Telephonic Behavioral Health..
... Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, ... Care Manager, Telephonic Behavioral Health 2 work assignments are varied and ... Care Manager, Telephonic Behavioral Health..
Job Information Humana Nurse Practitioner - CenterWell - Gastonia, NC in Gastonia North Carolina Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary ..
Job Information Humana Senior Accreditation Professional in Charlotte North Carolina Description ... Carolina Description The Senior Accreditation Professional works in a team environment ... performing complex tasks related to 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 Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..
... and processes necessary to maintain compliance with NCQA and MMOC standards ... leadership to achieve and maintain compliance. Collect and analyze data daily, ... of SCM nurses queues for..
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 Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
... and more productive in their professional and personal lives. We promote ... environment for all. Responsibilities The Compliance Professional 2 develops and implements compliance policies and procedures. Researches compliance..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... Healthy Horizons Mental Health Parity Compliance..
Description Be a part of the CenterWell leadership team, a subsidiary whose purpose is to provide care management program support resources to physicians, physician groups, and integrated healthcare delivery systems throughout ..
Description The Senior Compensation Professional develops, implements, and administers compensation programs. The Senior Compensation Professional 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 Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Job Information Humana Physician - CenterWell - Gastonia, NC in Gastonia North Carolina Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care ..
