Contract Compliance Specialist Jobs in Green Bay

Description The Financial Planning & Analysis Lead analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. The Financial Planning & Analysis ..

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 ..

... seeking a Software Entitlement and Compliance Specialist who will be accountable for ... including full software lifecycle management, compliance, optimization, audit data requests and ... Software Asset Management Entitlement..

Job Information Humana Medicare Appeals and Grievance Medical Director in Green Bay Wisconsin Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..

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 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, ..

... seeking a Software Entitlement and Compliance Specialist who will be accountable for ... including full software lifecycle management, compliance, optimization, audit data requests and ... where the Software Entitlement..

Job Information Humana Medical Director - Florida Medicaid in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..

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 Compliance Professional 2 - Medicaid in ... Capsule Be a part of Compliance - Use your business knowledge ... procedures, and programs supporting our compliance initiatives. Humana..

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 fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..

Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Green Bay Wisconsin Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is ..

Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of ... & Analytics to ensure continued compliance through innovative product offerings and ... and..

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 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 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 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 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 FP&A Lead, Medicaid Market in Green Bay Wisconsin Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..

Job Information Humana Medical Director - National Medicare Team in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work ..

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 ..

Job Information Humana UM Medical Director - Conviva in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..