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Regulatory Compliance Specialist IV The candidate manages an audit program portfolio for SOC, Healthcare (HIPAA, HITRUST), Finance (PCI), or SaaS@Customer to support and maintain existing audit compliance efforts and regulatory compliance ..
Description Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. As ... a whole. As a senior-focused healthcare provider, and subsidiary of..
Description o Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Job ID 21000KMPAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and policy requirements. Assists ..
Job Code 2172024 For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in San Antonio Texas Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is ..
Mission Control is a dynamic workspace, powered by teams who are passionate about the One Medical Mission, providing world class service experiences for patients, and who are never satisfied with the ..
... Certified Diabetes Care and Education Specialist-Remote-US in San Antonio Texas Description ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Job Information Humana Vendor Management Specialist 3 in San Antonio Texas ... Texas Description The Vendor Management Specialist 3 works as liaison between ... and organization. The Vendor Management Specialist..
Description The Stars Improvement Coordinator develops, implements, and manages ... Program. Directs all Stars quality improvement programs and initiatives. The Stars ... programs and initiatives. The Stars Improvement Coordinator performs..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
Job Information Humana Stars Improvement Coordinator - Remote TX in ... Antonio Texas Description The Stars Improvement Coordinator Quality Initiatives assists in ... Medicare Stars Program. The Stars Improvement Coordinator..
Job Information Humana FP&A Lead, Medicaid Market in San Antonio Texas Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..