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Description The Senior Vendor Management Professional with Humana manages a ... in an effort to reduce fraud, waste and abuse and increase ... and workflows in our project management software..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
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 ..
... Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in ... Charleston West Virginia Description The Fraud and Waste Professional 2 conducts ... fraudulent and abusive practices. The..
Job Information Humana Senior Risk Management Professional-Remote, US in Charleston West ... Virginia Description The Senior Risk Management Professional will support risk management efforts in the Data Governance, ... Data..
... Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Supervisor, ... solve basic problems; collaborates with..
... and clinical compliance, and case management. Serve as a Humana Military/Humana ... for quality standards, claims accuracy, fraud, and required clinical elements. Perform ... clinical elements. Perform telephonic case..
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..
... Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Compliance ... carriers Previous experience in utilization..
Description The CCM Compliance Professional 2 ensures compliance with governmental and contractual requirements. The CCM Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the ..
Job Information Humana Manager, Fraud and Waste-Remote US in Charleston ... West Virginia Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
... limited to), the oversight and management of a highly specialized/professional team ... - ensuring proper identification of fraud, waste and abuse, as well ... this exciting leadership opportunity within..
Description The Manager, 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 Manager, Compliance ..
... The Compliance Nurse reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Compliance ... plus Previous experience in utilization..
Description The Manager, Fraud and Waste, Genetic Counseling provides ... and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works ... and goals. Responsibilities The Manager, Fraud and Waste,..
