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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..
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 The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Senior Market ..
Job Information Humana Senior Accreditation Professional in Colorado Springs Colorado Description ... Colorado Description The Senior Accreditation Professional works in a team environment ... performing complex tasks related to 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 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 Quality Assurance, Clinical Professional requires being both a nurse/RN and a certified Coder nurse as this position will be cross trained to review DRG (Diagnosis Related Group) audits ..
Description The Quality Assurance, Clinical Professional 2 consults and collaborates with clinicians ... to ensure high accountability of compliance and quality. The Quality Assurance, ... quality. The Quality Assurance, Clinical..
... 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 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 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 CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
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 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 ..
... 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..
... Information Humana Medicaid Associate Director, Compliance Nursing in Colorado Springs Colorado ... Colorado Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 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 ..
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 ..
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..
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 ..
