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... in process consulting to support compliance within the Healthcare Services (HCS) organization. As a ... (HCS) organization. As a HCS Compliance & Risk Management Professional, you ... effectiveness and..
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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
Description The Senior Compliance and Quality Professional contributes to ... strategy by supporting quality and compliance initiatives across Service Operations teams ... and operating standards. The Senior Compliance and Quality..
... Information Humana Medicaid Associate Director, Compliance Nursing in Louisville Kentucky Description ... Kentucky Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description The Quality Compliance Nurse (RN) Professional uses quality ... for well-being Responsibilities The Quality Compliance Nurse (RN) Professional leads quality ... Follows established guidelines/procedures The Quality Compliance Nurse (RN)..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g. CPT) to patient records. The Medical Coding Auditor ..
Description The Senior Risk Management Professional will be responsible for managing third party risk management (TPRM) work streams to support Humana's overall TPRM Program. Responsibilities include risk identification, data analysis, process ..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... Healthy Horizons Mental Health Parity Compliance..
Description The Internal Audit Consulting Group (IACG) Quality Assurance Professional 2 develops, plans and evaluates internal audit programs for the organization's clinical business areas and related procedures to ensure compliance with ..
