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Assistant General Counsel, Office of the President Duties: Provide legal services addressing a variety of healthcare-related matters, including federal and state legal and regulatory issues governing the provision of health care, ..
... detecting and investigation of potential fraud and provide clinical guidance to ... reviewing of medical records for fraud, waste or abuse as well ... detecting and investigation of potential..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Las Vegas Nevada Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
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 Senior Care Manager, Behavioral Health (BCBA) This is a non-exempt position with responsibility for utilization management and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in ..
Job Information Humana Senior Fraud and Waste Investigator - Lab ... Vegas Nevada Description The Senior Fraud and Waste Investigator conducts investigations ... Work assigned to the Senior Fraud and..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Las Vegas Nevada Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review ..
... Seeking meaningful work? As a Fraud and Waste Manager at Humana, ... a nurse coder with prior fraud experience, proven leadership ability and ... of clinical investigations of alleged..
Description The Fraud and Waste Professional 2 conducts ... fraudulent and abusive practices. The Fraud and Waste Professional 2 work ... of reported, alleged or suspected fraud. Thoroughly documenting investigating..
Description The Fraud and Waste Professional 2 conducts ... fraudulent and abusive practices. The Fraud and Waste Professional 2 work ... courses of action. Responsibilities The Fraud and Waste Professional..
Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Description The Fraud and Waste Professional 1 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 1 work assignments are often straightforward and of moderate complexity. ..
... Humana Pharmacy Special Investigations Professional (Fraud, Waste & Abuse) Remote in ... Las Vegas Nevada Description The Fraud and Waste Professional 2 conducts ... fraudulent and abusive practices. The..
Description The Senior Fraud and Waste Professional conducts investigations ... and abusive practices. The Senior Fraud and Waste Professional work assignments ... variable factors. Responsibilities The Senior Fraud and Waste..
... Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in ... Las Vegas Nevada Description The Fraud and Waste Professional 2 conducts ... fraudulent and abusive practices. The..
Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The Nurse ..
Job Information Humana Fraud and Waste Investigator - Work ... is looking for an experienced Healthcare Investigator to join its industry ... have a passion for combating Fraud, Waste, and..
Senior Claims Business Process Analyst – Remote in Las Vegas, ... investigating and educating instances of healthcare fraud waste and or abuse by ... look for patterns for potential fraud..
Description The Senior Clinical Fraud and Waste Professional performs analysis ... abusive practices. The Senior Clinical Fraud and Waste Professional work assignments ... factors. Responsibilities The Senior Clinical Fraud and..
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 ..
