Manager Compliance Auditing Monitoring Jobs in Troy

Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is ... responsible for the administration and monitoring of the Autism Care Demonstration ... Exceptional Family Member Plan (EFMP), auditing for..

Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... Codes. KEY ACCOUNTABILITIES 95% Quality Monitoring Audits Review..

Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..

... The Director, Actuarial Risk and Compliance is responsible for the overall ... The Director, Actuarial Risk and Compliance requires an in-depth understanding of ... The Director, Actuarial Risk and..

Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Troy ... Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible ... responsible for the administration and monitoring..

WHS Governance and Compliance Manager The candidate will be responsible ... deploy a standard method for monitoring work performed by the team ... team. Lead process efficiency and compliance effectiveness..

Job Information Humana Senior Cloud Security Engineer (virtual remote) in Troy Michigan Description Responsibilities Our Department of Defense Contract requires U.S. citizenship for this position The Remote Senior Cloud Security Engineer ..

... Group product implementation, operations, contract compliance, and federal contract application submissions. ... and procedure Demonstrate third party monitoring and oversight practices consistent with ... with assigned third parties Support..

... environments to be always in compliance with Humana security and compliance policies. Lead, and collaborate with ... principles with Terraform, Azure Resource Manager, Docker, Kubernetes Monitor system uptime, .....

Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..

Job Information Humana Manager, Compliance - Agent Investigation Unit in ... in Troy Michigan Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Compliance works within specific guidelines..

Senior Manager Compliance Programs, Corporate Functions Duties: The ... team that maintains and enhances compliance program components, including, but not ... Identify needs, securing commitments and monitoring progress of deliverables..

NA WHS Senior Governance and Compliance Manager The candidate will lead a ... deploy a standard method for monitoring work performed by contractors, and ... standards. Lead process efficiency and..

Description The Compliance (UM) Coordinator 3 conducts and ... Coordinator 3 conducts and summarizes compliance audits. The Compliance (UM) Coordinator 3 performs advanced ... nation's largest full-service pharmacy benefits manager..

WHS Governance and Compliance Manager The candidate will be responsible ... deploy a standard method for monitoring work performed by the team ... team. Lead process efficiency and compliance effectiveness..

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

Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..

... Group product implementation, operations, contract compliance, and federal contract application submissions. ... and procedure Demonstrate third party monitoring and oversight practices consistent with ... with assigned third parties Support..

Description The Manager, Compliance - Medicaid State Reporting ensures ... - Medicaid State Reporting ensures compliance with governmental requirements. The Manager, Compliance - Medicaid State Reporting works ... perks for..

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). ..

Senior Manager Compliance Programs Duties: Manage a team ... team that maintains and enhances compliance program components. Provide support, coaching, ... annual performance evaluations. Research regulatory compliance requirements and develop..

Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..