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Description The Senior Quality Compliance Nurse (RN) utilizes quality improvement methodology and works collaboratively ... and interdisciplinary teams to monitor quality, outcomes, and compliance processes. This role works with .....
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..
... 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,..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in ... in Indianapolis Indiana Description The Risk Management Professional 2 identifies and .....
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 ..
... Information Humana AVP, Stars and Risk Adjustment National Medical Director in ... Indianapolis Indiana 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..
... communities and removing barriers to quality care. The work you do ... work.(sm) The utilization management (UM) manager is responsible for the supervisory ... discharge planning functions. The UM..
Job Information Humana Bilingual Quality Auditor in Indianapolis Indiana Description ... Indianapolis Indiana 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 ... Indianapolis Indiana Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... that leads Humana's Stars and..
... SCOPE: Manages the provision of quality patient care in an independent ... in accordance with all legal, compliance, and regulatory requirements and programs. ... costs, operational methods, growth, and..
... Inform residents of any potential risk during any procedures.10. Work with ... clinical competency.16. Participate in the quality improvement process.17. Promote the programs ... with the community.18. Act in..