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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, ..
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..
... Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... and to prevent and detect fraud, waste, and abuse. The Associate ... and quality performance and staffing..
Description Your Home Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving clinical and quality outcomes by bridging the gap between the physician's office and the member's home. YHA ..
... customer experience, continuous improvement, change management, data integrity and process-level measurements. ... 10% Working with ACD Care Management operational leaders, lead development of ... objectives. Required Qualifications Experience in..
... investigating and educating instances of healthcare fraud waste and or abuse by ... look for patterns for potential fraud waste and/or abuse Maintain accurate, ... thorough case information in..
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 ..
Company Name: Smith's Food and Drug Position Type: Employee FLSA Status: Non-Exempt Position Summary: Create an outstanding customer experience through exceptional service. Establish and maintain a safe and clean environment that ..
... 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..
... 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..
... sectors, from sports arenas and healthcare to higher education and convention ... The Cost Manager provides cost management services including invoice validation, cost ... cost forecasting and reporting, change..
... 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 Associate Director, Payment Integrity 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 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,..
... represents the Compliance and Risk Management Department in multi-departmental initiatives. This ... staying current on changes impacting healthcare compliance. Prepares compliance reports, guidance ... data analytics for internal senior..
Job Information Humana Manager, Fraud and Waste-Remote US in Las ... Vegas Nevada Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
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 ..
... to join the Claims Cost Management (CCM) Solutions Support team working ... team is to identify potential Fraud, Waste, and Abuse occurring with ... 4 years of experience in..
... position with responsibility for utilization management and clinical decision-making as outlined ... clinical information in various medical management systems. The associate understands department, ... limited to: 70% Performing utilization..
... 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 Assistant General Counsel provides a full range of legal advice and services. The Assistant General Counsel provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced ..
Description Humana's Claims Cost Management (CCM) organization is seeking a ... organization is seeking a Manager, Fraud & Waste to join the ... in the US. As the Fraud &..
