Healthcare Compliance Jobs

Job ID 21000JY8Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

... a strong rapport with the healthcare consumer, host and community. Represent ... practices and company initiatives. *Ensure compliance with recordkeeping and occurrence reporting ... relationship with collaborating physicians, other..

... systems as directed and in compliance with HIPAA regulations and Company ... coat, closed toe shoes in compliance with The Little Clinic Dress ... technicians to provide high-quality, convenient..

Description Humana Healthy Horizons in Louisiana is seeking a RN, Clinical Educator (Nursing Educator 2) who will plan, direct, coordinate, evaluate, develop, and/or deliver trainings and education programs for professional nursing, ..

... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... in accordance with all legal, compliance, and regulatory requirements and programs. ... all requirements of the FMCNA..

Details Department: Emergency Schedule: Full-time, salaried, Monday - Friday 8am - 5 pm Hospital: Ascension Franklin Location: Franklin, WI Benefits Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits ..

Description Humana Health Horizons in Louisiana is seeking Medicaid Quality Audit Professionals - Behavior Health (BH) to ensure contracted Specialized Behavioral Health Providers adheres to NCQA documentation standards, BH Clinical Practice ..

Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management (Behavioral Health) who will utilize clinical skills to support the coordination, documentation, and communication of behavioral health services and/or ..

Description The Behavioral Health Strategy Lead (Behavioral Health Coordinator) shall have responsibility for clinical program development and oversight of staff and services related to the delivery of covered mental health and ..

PURPOSE AND SCOPE:  The Credentialing Specialist is responsible for verifying submitted Credentialing documentation. for all specialties that provide services to the organization's members. The Credentialing Specialist incumbent will meet all credentialing ..

Job ID 21000M1GAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

... fraud, waste, and abuse (FWA) compliance program to prevent and detect ... out the provisions of the compliance plan, including FWA policies and ... Oversee internal investigations of FWA..

Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management Nursing who will utilize clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit ..

Description The Community Health Worker/Care Management Support Professional 1 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or ..

Job Code 2154509 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly ..

Description The Social Determinants of Health (SDOH) Coordinator understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed ..

... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... in accordance with all legal, compliance, and regulatory requirements and programs. ... all requirements of the FMCNA..

Description Humana Healthy Horizons in Louisiana is seeking an Associate Director, Utilization Management Nursing who will use clinical knowledge, communication skills, and independent critical thinking skills to provide the best and ..

Description Humana Healthy Horizons in Louisiana is seeking an Associate Director, Care Management who will use clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most ..

... procedures for local and state compliance. Essential Functions: Provides oversight of ... 5 years previous experience in healthcare, preferably rehabilitation experience Prior experience ... a different level. Job :..

Description Humana Health Horizons in Louisiana is seeking a Behavioral Health (BH) Children's System Administrator (Care Management Behavioral Health Lead) who will advise on program features to reach members and drive ..

Description Humana Healthy Horizons in Louisiana is seeking a Manager, Community Management who will work to reduce health disparities and promotes health equity and population health. The Manager, Community Management is ..

... direction of a RN in compliance with the state's Nurse Practice ... any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, ... manager(s), other members of the..