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Compliance Manager The candidate will manage foundational ... initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk ... accreditations, on-site reviews, risk assessments; audit planning, conducting mock audits,..
Description Humana's Medicaid Behavioral Health Medical Director will oversee our behavioral health (BH) clinical program for Medicaid plan members. They will collaborate closely with the Chief Medical Officer (CMO) and the ..
Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
... of Enterprise Information Protection (EIP), Internal Audit, Enterprise Risk Management, business units, ... to ensure engagements with key internal, regulatory and industry groups to ... and industry groups to..
... mitigate risk associated with external audit reviews. Responsible for driving accuracy ... and/or Auditing experience in the Healthcare Industry Experience in a production ... a production goal-oriented environment within..
... 40) market leader in integrated healthcare whose dream is to help ... for the role of Director, Internal Audit. In this role, you will ... this role, you will..
... Job Description The IT Project Manager 2 will lead the IT ... a strong ability to manage internal and external resources, remotely and ... with Information Security Risk Management,..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Job Information Humana Manager, Compliance - Agent Investigation Unit ... in Cincinnati Ohio Description The Manager, Compliance ensures compliance with governmental ... compliance with governmental requirements. The Manager, Compliance works..
Description The Director, IT Compliance audits the most complex new and existing information systems applications to ensure that appropriate controls exist, that processing is efficient and accurate, and that information systems ..
... Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, ... Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2, ... include: Collaborate with the Quality..
... looking for an experienced Senior Healthcare Investigator to join its industry ... practices. Prepares complex investigative and audit reports. Begins to influence department's ... o Able to collaborate with..
Job Information Humana Strategy Advancement Lead, Senior Products Actuarial in Cincinnati Ohio Description The SPA Process and Models Lead supporting the execution of core Senior Product Actuarial processes and projects provides ..
... appropriate responses to regulatory exams, internal and external audits, requests for ... in responding to regulatory and/or audit exams, a strong understanding of ... skills, both oral and written..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Cincinnati Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
... operational and compliance risks, evaluating internal and external audit results, researching new/emerging regulatory guidance, ... activities Identify and document key internal controls; develop strategies for periodic ... to ensure..
Job Information Humana Manager, Fraud and Waste-Remote US in ... in Cincinnati Ohio Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..
... (CCM) organization is seeking a Manager, Fraud & Waste to join ... join the Provider Payment Integrity-Clinical Audit team working remote anywhere in ... As the Fraud & Waste..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Cincinnati Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
... is looking for an experienced Healthcare Investigator to join its industry ... billing practices. Prepares investigative and audit reports. Begins to influence department's ... o Able to collaborate with..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Cincinnati Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..