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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..
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TRS Healthcare is seeking an experienced Progressive Care Unit Registered Nurse for an exciting Travel Nursing job in Tallahassee, FL. Shift: 3x12 hr days Start Date: 03/28/2022 Duration: 13 weeks Pay: ..
... 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 Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires ..
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). ..
Description The Community Health Worker contributes to the administration of Care Management and Utilization Management. The individual in this role provides non-clinical support to the assessment and evaluation of member's needs ..
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 ..
Description The Grievances & Appeals Professional 2 manages client medical denials by ... warranted. The Grievances & Appeals Professional 2 work assignments are varied and ... Responsibilities The Grievances &..
**Company :**Highmark Inc.**Job Description :****JOB SUMMARY**This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA and ACA), using skills including but not ..
... Health LPN, you will: Provide professional nursing services under the direction ... direction of a RN in compliance with the state's Nurse Practice ... Maintain the highest standards of..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care ..
... 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..
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..
... to ensure documentation is in compliance with regulatory agencies and requirements ... are completed timely and in compliance with Medicare regulations. Coordinates communication ... policies and procedures to ensure..
