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... candidate must be an insightful risk-taker willing to thoughtfully disrupt the ... team as necessary to ensure compliance with all local policies and ... and clinical claims reviews Assure..
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..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in ... Charlotte North Carolina Description The Risk Management Professional 2 identifies and .....
... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... policy requirements. Ensure provision of quality patient care while maintaining cost-effective ... in accordance with all legal,..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Description The Manager, Risk Adjustment oversees coding educators and ... Adjustment oversees coding educators and quality assurance audits of medical records ... and Medicaid Services (CMS). The Manager, Risk Adjustment..
... Information Humana AVP, Stars and Risk Adjustment National Medical Director in ... North Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... national planning and operations for..
Job Information Humana Bilingual Quality Auditor in Charlotte North Carolina ... North Carolina Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..
... Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership ... North Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... that leads Humana's Stars and..
