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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..
... career development. Superior training, UltraCare® quality control, and certification procedures ensure ... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... the FMCNA commitment to the..
... Member_** At Sunrise, our Care Manager is responsible for providing the ... providing the highest degree of quality care and services to a ... to ensure community is in..
... Information Humana AVP, Stars and Risk Adjustment National Medical Director in ... Allen Virginia Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... national planning and operations for..
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..
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 ..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in ... Glen Allen Virginia Description The Risk Management Professional 2 identifies and .....
... economically only if we deliver high-quality patient outcomes and satisfaction. As ... our clinical teams can spend quality-time caring for a smaller number ... are now the nationu2019s largest..
Job DescriptionNurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member ..
... Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership ... Allen Virginia Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... that leads Humana's Stars and..
Job Information Humana Bilingual Quality Auditor in Glen Allen Virginia ... Allen Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..
