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Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Chicago Illinois Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with an Inpatient Senior Medical Coding Auditor roles! This is a unique team that's primary role is to ..
... looking for a dynamic Registered Nurse to join the team working ... overpayments when they happen. The Nurse Auditor 2 validates and interprets medical ... Qualifications Associate's Degree Active..
Description The Nurse Auditor 2 performs clinical audit/validation processes ... to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied ... courses of action. Responsibilities The Nurse Auditor..
Job Information Humana Manager, Care Management (Illinois Medicaid) - The Greater Chicago Area in Chicago Illinois Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Description The Nurse Auditor 2 performs clinical audit/validation processes ... to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied ... Humana is looking for a Nurse Auditor..
Description The Nurse Auditor 2 performs clinical audit/validation processes ... support optimal reimbursement. Responsibilities The Nurse Auditor 2 validates and interprets medical ... Required Qualifications BSN Active Registered Nurse (RN)..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in ... in Chicago Illinois Description The Nurse Auditor 2 performs clinical audit/validation processes ... to support optimal reimbursement. The Nurse..
... the team with a Senior Nurse Auditor roles! This is a unique ... should strongly consider the Senior Nurse Auditor opportunity with Humana. Performs clinical ... - Required Qualifications..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Medical Coding Auditor roles! This is a unique team that's primary role is to quickly ..
Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
Description Humana's Claims Cost Management (CCM) organization is seeking a Manager, Fraud & Waste to join the Provider Payment Integrity-Clinical Audit team working remote anywhere in the US. As the Fraud ..
Description The Nurse Auditor 2 performs clinical audit/validation processes ... support optimal reimbursement. Responsibilities The Nurse Auditor 2 validates and interprets medical ... guidelines/procedures. Required Qualifications Active Registered Nurse (RN)..
Description The Nurse Auditor 2 will work on the ... clinical lab audit concepts. The Nurse Auditor 2 will perform clinical audit ... fraud, waste, and abuse. The Nurse Auditor..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Chicago Illinois Description The Risk Management Professional 2 identifies and analyzes potential sources of ..
... The SIU and PPI Lab review team is seeking a Medical ... is seeking a Medical Coding Auditor with a special set of ... focus on coding and clinical..
