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SVP, Deputy CCO Responsibilities: Lead the team responsible for regulatory exams and inquiries and other regulatory affairs; as well as responsible for performing regulatory event (both internal and external) tracking and ..
... market. Responsibilities The Clinical Documentation Specialist (CDS) follows state and federal ... medical records. The Clinical Documentation Specialist conducts medication reviews of charts ... clinical diagnoses. The Clinical Documentation..
Description The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Lancaster South Carolina Description The Fraud and Waste Professional 2 conducts investigations of allegations ..
Job Information Humana Senior Contract Tools, Education, Processes Professional - Remote in Lancaster South Carolina Description The Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and protocol, case ..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Job Information Kindred at Home Weekend RN - Fulltime Registered Nurse for Weekend Home Health - Car, Salary & Sign On Bonus in Monroe North Carolina The Clinical Assessment Advisor - ..
Job Information Humana UM Administration Coordinator 2 (Schedule: Monday - Friday) - Remote in Lancaster South Carolina Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM ..
Job Information Humana Provider Data Management & Contract Load Professional 2 - Remote, nationwide in Lancaster South Carolina Description Do you thrive in a fast-paced environment? Are you a self-starter and ..
Description We are seeking a driven individual to support the Stars program to positively impact HEDIS performance through delivery of strategic initiatives and operational excellence. The role will support the preventive ..
Job Information Humana Pharmacy Special Investigations Professional (Fraud, Waste & Abuse) Remote in US in Lancaster South Carolina Description The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent ..
Description The Data and Reporting Professional 2 generates ad hoc reports and regular datasets or report information for end-users using system tools and databases. The Data and Reporting Professional 2 work ..
Job Information Centerwell Home Health Admissions RN in Fort Mill South Carolina The Clinical Assessment Advisor directly completes and oversees development/ of the plan of treatment as approved by physician, performs ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Lancaster South Carolina Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review ..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
Job Information Kindred at Home Administrative Specialist / Human Resources Designee in Monroe North Carolina The Administrative Specialist / Human Resources Designee is responsible for ensuring agency staff is supported related ..
Description The Quality Assurance, Clinical Professional 2 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work assignments are varied and ..