Compliance Professional 2 Jobs in Riverton

Description The Senior Compliance Professional will help to reach compliance program objectives by ensuring compliance with governmental regulations and laws, ... business areas. Responsibilities The Senior Compliance Professional will: Oversee..

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

Job Information Humana Assoicate Actuary, Pricing MA-PD Medicare Advantage Prescription Drug-2 in Riverton Wyoming Description The Associate Actuary role is a newly created role within the Senior Products Actuarial Medicare Advantage ..

... The Senior Fraud and Waste Professional conducts investigations of allegations of ... The Senior Fraud and Waste Professional work assignments involve moderately complex ... a thorough investigation to maintain..

Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Riverton Wyoming Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

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 fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

... multiple managers or highly specialized professional associates. Responsibilities include: Leads National ... practices and process opportunities. Assure compliance with state timeframes for turnaround ... Utilization Management operational leadership experience...

Description The Health Information Management Professional 2 ensures data integrity for claims ... errors. The Health Information Management Professional 2 work assignments are varied and ... Responsibilities The Health Information..

Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Riverton Wyoming Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ..

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..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

... 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..

Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..

Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..

... is seeking a Nursing Educator 2 who will plan, direct, coordinate, ... training and education programs for professional nursing personnel. The Nursing Educator ... nursing personnel. The Nursing Educator..

Description The Senior Accreditation Professional works in a team environment ... performing complex tasks related to compliance with accreditation standards across multiple ... Home Anywhere The Senior Accreditation Professional works..

Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..

Job Information Humana Director, Informatics in Riverton Wyoming Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..

Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..

Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..

... 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..