Manager Regulatory Compliance Jobs in Louisville

Program Manager-Patient Safety, Quality, Risk and Safety, ... MARY AND ELIZABETH HOSP.','','!*!The Program Manager, Patient Safety coordinates the patient ... optimize patient safety. The Program Manager, Patient Safety is responsible..

Division Manager-QUALITY PHYSICIAN SVCS','Full-time','Director/Manager/Supervisor','8a','8a','80','80','None','None','KENTUCKY-LOUISVILLE-JEWISH HOSP 200 ABRAHAM FLEXNER','','!*!This role ... managing The Jewish Physician Group Quality/compliance Program, including participating in committee ... Oversees preparation for review by regulatory agencies, educates..

Description The Compliance Nurse 2 reviews utilization management ... fraud, waste, and abuse. The Compliance Nurse 2 work assignments are ... courses of action. Responsibilities The Compliance Nurse 2 ensures..

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..

Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..

Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

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..

... Information Humana Medicaid Associate Director, Compliance Nursing in Louisville Kentucky Description ... Kentucky Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..

Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..

Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Louisville Kentucky Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to lead ..

Job Information Centerwell RN Clinical Manager Home Health Full Time in ... in Louisville Kentucky The Clinical Manager coordinates and oversees all direct ... to ensure documentation is in compliance..

... Home Advantage (YHA) Market Clinical Manager (MCM) will lead a team ... Assessments (IHWA). The Market Clinical Manager provides leadership, clinical management and ... practice providers. The Market Clinical..

Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Louisville Kentucky Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..

... seeking a HEDIS Senior Data Manager to deliver quality and value ... including IT, Quality Operations and Compliance, and Risk Adjustment, as well ... Responsibilities The HEDIS Senior Data..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Louisville Kentucky Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..