Healthcare Compliance Jobs

SOCIAL WORKER-HOSPICE-MSW','Full-time','Professional Clinical/Allied Health','M - F','M - F','64','64','None','None','MINNESOTA-ALBANY-ALBANY HEALTH AT HOME','','!*! HOSPICE SOCIAL WORKER Job Summary / Purpose The social worker is responsible for the implementation of standards of care for ..

Job Location GA FFT-DJJ Albany - Albany, GA Position Type Full Time Education Level Masters Degree Travel Percentage Up to 50% Job Shift Various Shift Hours Job Description Community Solutions, Inc. ..

... Information Humana Medicaid Associate Director, Compliance Nursing in Albany New York ... York Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..

... Information Humana Actuary, Risk and Compliance in Albany New York Description ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..

Description Responsibilities This position will maintain the Humana Military ACD website Autism Center of Excellence (CoE); ensuring educational information is current and relevant to training needs in addition to analyzing and ..

Description Responsibilities The Autism Care Demonstration (ACD) Senior Learning Design Professional analyzes content, organizes content, designs solutions, and writes storyboards, scripts, performance support, newsletters and notification letters. Analyzes learning needs and ..

Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in Albany New York Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for ..

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 Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..

... support of remote dispensing and compliance in Hospice IPU (Inpatient Unit) ... support of remote dispensing and compliance in Hospice IPU settings. Essential ... Daily generation and review of..

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 Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..

Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..

... within a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..

Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..

Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..

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 Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..

Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..

Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..

Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..

Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities Seeking Senior..

... performing complex tasks related to compliance with accreditation standards across multiple ... performing complex tasks related to compliance with accreditation standards across multiple ... resolving deficiencies that impact plan..