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Associate General Counsel Duties: Providing advice and counsel to group on a wide range of compliance, regulatory, operational and transactional matters. Collaborating on the legal aspects of the health system’s operations, ..
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..
... Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in ... Newport Rhode Island Description The Fraud and Waste Professional 2 conducts ... fraudulent and abusive practices. The..
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 ..
... 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..
... 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..
Job Information Humana Manager, Fraud and Waste-Remote US in Newport ... Rhode Island Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..
... 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..
Job Information Humana Senior Risk Management Professional-Remote, US in Newport Rhode ... Island Description The Senior Risk Management Professional will support risk management efforts in the Data Governance, ... Data..
... 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 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 &..
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 ..
... 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 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 ..
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 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 ..
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,..
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 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 ..
Job Information Humana Manager of Fraud and Abuse Data Analytics in ... Description Responsibilities The Manager of Fraud and Abuse Data Analytics will ... for the supervision of the Fraud..
