Healthcare Fraud Management Jobs

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..

... procedures and systems, including access management for hardware, firmware and software. ... delivery at the intersection of healthcare and technology. If you thrive ... create them. We launched a..

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 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 &..

... Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in ... in Salem Oregon Description The Fraud and Waste Professional 2 conducts ... fraudulent and abusive practices. 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 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 ..

... 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..

... 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 Senior Risk Management Professional-Remote, US in Salem Oregon ... Oregon Description The Senior Risk Management Professional will support risk management efforts in the Data Governance, ... Data..

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 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 ..

... 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..

... 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..

Job Information Humana Manager, Fraud and Waste-Remote US in Salem ... Salem Oregon Description The Manager, Fraud and Waste conducts investigations of ... and abusive practices. The Manager, Fraud and..

... 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..