Compliance Professional 2 Jobs in Georgia

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 ..

... (ACD) team performance to ensure compliance with contract and complex ACD ... Section 4. Responsibilities The Senior Compliance Professional responsibilities include analyzing data, reporting ... ACD associates to assure..

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 ..

... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... in accordance with all legal, compliance, and regulatory requirements and programs. ... all requirements of the FMCNA..

... 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..

Job Information Humana Senior Accreditation Professional in Atlanta Georgia Description The ... Georgia Description The Senior Accreditation Professional works in a team environment ... performing complex tasks related to compliance..

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 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..

... your personal attention and kindness, professional insight, and a generosity of ... the best possible outcomes and professional satisfaction. While our extensive organization ... of camaraderie, emphasizing friendly collaboration,..

... Information Humana Medicaid Associate Director, Compliance Nursing in Atlanta Georgia Description ... Georgia Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..

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 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 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 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 - Atlanta, GA - Old National in Atlanta Georgia Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a ..

... and more productive in their professional and personal lives. We encourage ... industry as a whole. The Compliance Nurse 2 reviews utilization management activities and ... fraud, waste, and..

... The Senior Medical/Financial Risk Evaluation Professional is responsible for supporting the ... The Senior Medical/Financial Risk Evaluation Professional work assignments involve moderately complex ... The Senior Medical/Financial Risk Evaluation..

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..

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 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 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 ..