Contract Compliance Specialist Jobs in Lancaster

Description The Compliance Lead (SNP) ensures compliance with governmental requirements. The Compliance Lead works on problems of ... moderate to substantial. Responsibilities The Compliance Lead (SNP) develops and implements .....

... 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..

... 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..

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 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..

Job Information Humana FP&A Lead, Medicaid Market in Lancaster South Carolina Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..

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 home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Lancaster South Carolina Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..

Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead will analyze business requirements, ... in a manner that minimizes compliance risk exposure for the Company. ... day-to-day..

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 ..

... contractors, provider relations, clinical/quality team, contract management and shared services. Will ... based on complaints, changes in contract language, reporting and trending Ensures ... process for tracking of network..

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..

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

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

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, ..

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 Medical Director - Florida Medicaid in Lancaster South Carolina 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 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 Lancaster South Carolina Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..

Job Information Humana Senior Provider Engagement Professional in Lancaster South Carolina Description The Senior Provider Engagement Professional is responsible for day-to-day back-end relationships and serves as liaison with network contractors, provider ..