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... 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 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..
... care, services, and supports in compliance with Ohio Department of Medicaid ... policies and procedures to ensure compliance with state and federal requirements ... and provide regular opportunities for..
Description The Senior Quality Compliance Nurse Professional is an integral part of ... projects. Responsibilities The Senior Quality Compliance Nurse Professional will partner with The Ohio ... as directed. The..
Description Senior Compliance Professional ensures compliance with governmental requirements as they ... Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex ... variable factors. Responsibilities The Senior..
Job Information Humana Care Guide - Physical Health in Lima Ohio Description The Care Guide (Care Coach 1) assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
... Care Manager, Licensed Behavioral Health Professional or Registered Nurse in Lima ... Field Care Manager, Behavioral Health 2 (Care Manager, Behavioral Health) assesses ... Field Care Manager, Behavioral Health..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
... Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in ... Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, ... insurance. The Senior Provider Contracting..
