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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 ..
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Description The Quality Assurance, Clinical Professional 2 consults ... to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work ... courses of action. Responsibilities The..
Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... Healthy Horizons Mental Health Parity Compliance..
... within a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... meeting departmental expectations, and meets..
... on medical record documentation for quality and clinical compliance with contract requirements as outlined ... for this position . 75% Quality Monitoring Audits. Review and assess ... ensure all..
Description The Principal Quality Leader will lead testing and ... Leader will lead testing and quality collaboration between Business and IT, ... tools and assure adherence to quality standards. Serves..
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 ..
... Member Plan (EFMP), auditing for quality and clinical compliance, and case management. Serve as ... ABA treatment plans for policy compliance. Assist with analysis of necessary ... Review outcome..
Description Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional ... to ensure high accountability of compliance and quality and claims are being reviewed ... implements programs to establish high..
... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... procedures, and training and in compliance with regulations set forth by ... the FMCNA commitment to the..
... Information Humana Medicaid Associate Director, Compliance Nursing in Washington District Of ... Columbia Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
... performing complex tasks related to compliance with accreditation standards across multiple ... performing complex tasks related to compliance with accreditation standards across multiple ... the development and implementation of..
... Information Humana Medicaid Associate Director, Compliance Nursing in Bethesda Maryland Description ... Maryland Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description Responsibilities The Compliance Professional 2 has responsibilities for ... on medical record documentation for quality and clinical compliance with contract requirements as outlined ... CPT Codes. KEY ACCOUNTABILITIES 95%..
Description The Senior Quality Assurance, Clinical Professional requires being ... to ensure high accountability of compliance and quality and will work assignments involving ... Categories) coding documentation guidelines and compliance..
