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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 Compliance Lead (Medicaid Contract Administrator) ensures ... Lead (Medicaid Contract Administrator) ensures compliance with governmental requirements, works on ... from moderate to substantial. The Compliance Lead (Medicaid Contract..
... 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..
... 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..
... 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..
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 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..
... 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..
... Information Humana Medicaid Associate Director, Compliance Nursing in Lancaster South Carolina ... Carolina Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 ..
Job Information Humana Senior Accreditation Professional in Lancaster South Carolina Description ... Carolina Description The Senior Accreditation Professional works in a team environment ... performing complex tasks related to compliance..
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 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 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 ..
... (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..
... valuation, pricing, analytics, forecasting, risk, compliance, and operations. Understands own work ... operations. Understands own work area professional concepts/standards, regulations, strategies and operating ... guided by precedent and/or documented..
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 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 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 ..
