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... Humana Medicaid Associate Director, Compliance Nursing in Lancaster South Carolina Description ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description Humana's recently created Clinical Resource Team is looking to ... Do you have a solid clinical background in acute care? Well, ... Auditor opportunity with Humana. Performs clinical audit/validation..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product ... Product Strategy team. The Senior Clinical Business Professional work assignments involve ... at home anywhere..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description Responsibilities The Quality Improvement Lead provides strategic leadership for Humana's South Carolina Medicaid Quality Program, in alignment with organizational quality and population health goals and ensuring compliance with all contract, ..
... will be responsible for performing clinical audits on medical record documentation ... record documentation for quality and clinical compliance with contract requirements as ... of three (3) years of..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, ... plan. The Senior Provider Engagement, Clinical Professional work assignments involve moderately ... Responsibilities The Senior Provider Engagement, Clinical..
... their health partners. Humana's Enterprise Clinical Operating Model (ECOM), is a ... outcomes through better integrating Humana's clinical capabilities, processes, and technology. This ... across Humana Responsibilities The Director,..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
Description The Senior Clinical Strategy and Practice Professional builds ... strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The ... within the enterprise..
