Director Clinical Quality Compliance Jobs

... Program, which involves ensuring regulatory compliance and actively overseeing quality assurance performance improvements.u003cspanu003eu0026nbsp; u003c/spanu003eAdditionally, the ... records, logs, and systems in compliance with HIPAA regulationsu003c/spanu003eu003c/liu003enu003cliu003eu003cspanu003eImplements all Program ... about..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Portland Maine Description ... Portland Maine Description The Associate Director, Compliance Nursing reviews utilization management activities ... waste, and abuse. The..

Description The Director, Strategy Advancement provides data-based strategic ... along the way. Responsibilities The Director, Retail Strategy & Product Advancement ... corporate vision, as well as compliance and regulatory expectations..

Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies ... HPS executive leaders, Trade Relations, Clinical, Analytics, Actuaries, and Operation functions ... the formulary strategies. Responsibilities The Director, Pharmacy..

Description The Medical Director actively uses their medical background, ... within a context of regulatory compliance, and work is assisted by ... resources, which may include national clinical guidelines, CMS..

Job Information Humana Medical Director - Florida Medicaid in Portland ... Portland Maine Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..

Description The Medical Director actively uses their medical background, ... within a context of regulatory compliance, and work is assisted by ... resources, which may include national clinical guidelines, CMS..

Job Information Humana Director, Care Delivery and EMR/EHR Technology ... in Portland Maine Description The Director, Technology Solutions devises an effective ... and the core EMR/EHR. The Director, Technology Solutions..

Job Information Humana Director, Care Delivery and EMR/EHR Technology ... in Portland Oregon Description The Director, Technology Solutions devises an effective ... and the core EMR/EHR. The Director, Technology Solutions..

Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... within a context of regulatory compliance, and work is assisted by ... resources which may include national clinical..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in ... Portland Maine Description The Medical Director relies on clinical background and reviews Medicare drug ... Medicare drug requests. The..

... and Risk Adjustment National Medical Director in Portland Maine Description The ... Portland Maine Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... and 3) contribute as a..

Job Information Humana Director, Informatics in Portland Maine Description ... in Portland Maine Description The Director, Informatics coordinates with other analytics, ... insights from knowledge SMEs. The Director, Informatics requires..

Job Information Humana Medical Director - National Medicare Team in ... Portland Maine Description The Medical Director relies on medical background and ... requests for services. The Medical Director work..

Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors Responsibilities The Medical Director actively uses..

... Job Description Summary The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Description The Medical..

... MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Portland ... Portland Maine Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... The Associate VP for Healthcare..

Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director will provide..

Job Information Humana UM Medical Director - Conviva in Portland Maine ... Portland Maine Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director..

Description The Medical Director's primary responsibility is the review ... level of care. The Medical Director's work assignments involve moderately complex ... variable factors that rely on clinical experience and..

Description The Behavioral Health Medical Director responsible for behavioral health care ... operations. The Behavioral Health Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director..

Job Information Humana Medical Director - S. Florida in Portland ... Portland Maine Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..

Job Information Humana Medical Director - Texas in Portland Maine ... Portland Maine Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..