Managed Care Compliance Jobs in Wilmington

ALL ABOUT TARGET As part of our collaborative and guest-obsessed team, you help us create an experience that makes guests say, “I love Target!” When you work at Target, you’re helping ..

... 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 Senior Market Data Professional - Remote in Wilmington North Carolina Description The Senior Market Data Professional provides support to assigned health plan and/or specialty companies relative to Medicare, ..

... 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..

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 Quality Improvement Coordinator in Wilmington North Carolina Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. ..

... 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,..

Health Care Attorney The candidate must have a J.D. degree from an ABA-accredited law school. Excellent academic credentials and 7 years of transactional and regulatory healthcare experience. Should have experience working ..

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 ..

... 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..

... to increasing patient access to care, lowering costs and improving the ... and improving the quality of care. Millions of times a day, ... shaping the future of health..

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 ..

... 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..

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

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). ..

Job Information Humana Storage Administrator- Storage and Backup in Wilmington North Carolina Description At Humana we are committed to helping people live healthy and happy through personalized care. Following the same ..

**Job Description Summary** The Lead Proposals demonstrates accountability for functional, business, and broad company objectives. In this role you will create, integrate and develop customer offerings that meet business needs across ..

... 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 .....

This role is based in Wilmington, NC Job Description Essential Responsibilities : The role involves leading engineers towards development, verification, validation, and maintenance of current and advanced computational methods for thermal-hydraulic ..

... coordinates and oversees all direct care patient services provided by clinical ... operations for a specific location managed. Conducts/delegates the assessment and reassessment ... of patients, including updating of..

REQUISITION NUMBER: 114705  JOB DESCRIPTION Cintas is seeking an Office Support Professional to support numerous office functions. Responsibilities include accounts receivable, accounts payable, data entry, receptionist, faxing, filing, photocopying, managing incoming ..

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 ..

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