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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 Credentialing Professional 2 obtains and reviews documentation to ... a health plan. The Credentialing Professional 2 work assignments are varied and ... of action. Responsibilities The Credentialing Professional..
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..
... 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 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 ..
... Information Humana Medicaid Associate Director, Compliance Nursing in San Antonio Texas ... Texas Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 ..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in San Antonio Texas Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for ..
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 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 ..
... 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 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..
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 ..
Job Information Humana Senior Accreditation Professional in San Antonio Texas Description ... Texas Description The Senior Accreditation Professional works in a team environment ... performing complex tasks related to 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 ..
Description o Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical ..
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 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..
