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Description The Compliance Lead (Medicaid Contract Administrator) ensures ... Lead (Medicaid Contract Administrator) ensures compliance with governmental requirements, works on ... from moderate to substantial. The Compliance Lead (Medicaid Contract..
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..
Job Information Humana Bilingual Quality Auditor in Lancaster South Carolina ... South Carolina Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..
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..
... Information Humana AVP, Stars and Risk Adjustment National Medical Director in ... South Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... national planning and operations for..
... 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 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 ... Lancaster South Carolina Description The Risk Management Professional 2 identifies and .....
... Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership ... South Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... that leads Humana's Stars and..
