Healthcare Quality Compliance Jobs

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 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..

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..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Dover Delaware Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..

Job Information Humana Bilingual Quality Auditor in Dover Delaware Description ... Dover Delaware Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..

... in Dover Delaware Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician..

Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional ... action. Responsibilities As a HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional..

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..

... in Dover Delaware Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) relies ... guidance to ensure..

POSITION FEATURES:*12 weeks of PAID training, no experience required*Competitive pay*Pay increase when certified (required within 18 months)*No Sundays, e/o Saturday*Tuition reimbursementDescriptionProvide your personal attention and kindness, professional insight, and a generosity ..

Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are ... courses of action. Responsibilities The Quality Compliance Professional 2..

Job Information Humana Utilization Management Registered Nurse, RN 2 in Dover Delaware Description The Utilization Management Nurse applies a Person-Centered approach, works within specific guidelines and procedures; applies advanced technical knowledge ..

Description The Manager, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Manager, Compliance Nursing works within specific guidelines ... and goals. Responsibilities The Manager, Compliance Nursing ensures..

... performance, policies and procedures, ensuring compliance with legal, organizational, and home ... care delivery model by assessing quality and efficiency and leading appropriate ... progressive leadership experience in the..

... Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities ... fraud, waste, and abuse. The Compliance Nurse work assignments are varied ... schedule and overtime. Responsibilities The..

Job Information Humana Quality Improvement Coordinator in Dover Delaware ... in Dover Delaware Description The Quality Improvement Coordinator 3 assists in ... assists in administering and monitoring quality improvement and..

... procedures, and training and in compliance with regulations set forth by ... the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI ... patients will achieve the FMC..

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..

Job Information Humana Director, Informatics in Dover Delaware Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..

... education sessions. Participate in the quality improvement process by responding appropriately ... programs and services of Heritage Healthcare through formal and informal interactions ... with the community. Act in..

... Information Humana Medicaid Associate Director, Compliance Nursing in Dover Delaware Description ... Delaware Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..

... Information Humana Senior Insurance Product Compliance Professional in Dover Delaware Description ... Description The Senior Insurance Product Compliance Professional Performs consultation and research ... development. The Senior Insurance Product..