Managed Care Compliance Jobs in Columbia

Compliance Analyst Duties: Create and maintain ... state regulatory submissions/reporting calendar, AHP Compliance Toll-Free Hotline, CMS Complaint Tracking ... stakeholders accordingly. Participate on various compliance subcommittees and workgroups. Perform periodic..

Compliance Analyst The candidate will assist ... assist in maintaining an internal compliance program; guide special projects; provide ... projects; provide regulatory interpretation; perform compliance reporting; and develop and implement..

... best and most appropriate treatment, care or services for members. Coordinates ... other parties to facilitate optimal care and treatment. Decisions are typically ... and processes necessary to maintain..

Job Information Humana Sr. DevOps Cloud Engineer in Columbia Tennessee Description Do you thrive on working on leading edge technology such as AKS and Kubernetes? Do you embrace the DevOps workstyle ..

Job Information Humana Director, Care Delivery and EMR/EHR Technology in ... IT business initiatives specific to care delivery technology and the core ... capabilities interrelate across Humana's Primary Care segment,..

Job Information Humana Storage Administrator- Storage and Backup in Columbia Tennessee Description At Humana we are committed to helping people live healthy and happy through personalized care. Following the same mantra, ..

... for this position include plan compliance, Request for Proposal (RFP) development, ... facilitate delivery to client; prepare compliance and transparency authorization to the ... general health and welfare plan..

... to drive operational excellence, advance compliance results, and improve audit readiness. ... Design, deliver, and drive internal compliance measures through the implementation of ... across multiple teams to improve..

Description The Project Manager manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Project Manager work assignments are varied ..

... and value, while also managing compliance with network requirements, including network ... Department of Health of Medicaid Managed Care Contract. The Lead will support ... proactively identify network issues,..

... best and most appropriate treatment, care or services for members. Coordinates ... other parties to facilitate optimal care and treatment. Decisions are typically ... and processes necessary to maintain..

... increase customer satisfaction and ensure compliance with established company and regulatory ... staff members are in full compliance with all FMCNA and FMCRx ... in operational activities to ensure..

Job Information Humana Quality Improvement Coordinator in Columbia Tennessee Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The ..

... follows manufacturer’s recommendations and in compliance with company policies and procedures, ... tracking/documentation systems as assigned. Regulatory Compliance: Participates in monthly Technical CQI/QAI ... water system documentation to verify..

Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..

... plan related to claims Ensure compliance with South Carolina's Managed Care Contractual requirements for provider relations, ... working with or in health care administration setting Exceptional relationship management .....

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..

... Medicaid Innovation) Multi-Payor and Accountable Care Initiatives. Responsibilities Immediately leverages a ... of big-picture vision, deep value-based care experience and a 'seeking to ... such as clinical, legal, and..

... across members, providers, agents, clinical, care management, pharmacy, and other units. ... new benefits launch, provider find care, provider management self-service, and provider ... management. Innovate on clinical and..

Job Information Humana Senior Market Data Professional - Remote in Columbia Tennessee Description The Senior Market Data Professional provides support to assigned health plan and/or specialty companies relative to Medicare, Medicaid, ..

(This will open in a new window from which you will be automatically redirected to an external site after 5 seconds) Job Overview Job Title: Auto Physical Damage Claim Representative Trainee ..

Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..

Job Information Humana Associate Director, Provider Data Interoperability in Columbia Tennessee Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient business solutions for quality assurance and ..