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... Member Plan (EFMP). Auditing for quality and clinical compliance, and case management. Serve as ... Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Psychologist (PhD), Registered ... Counselor (LPC),..
... and processes necessary to maintain compliance with NCQA and MMOC standards ... leadership to achieve and maintain compliance. Collect and analyze data daily, ... of SCM nurses queues for..
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Description The Quality Assurance, Clinical Professional 2 consults and collaborates with ... to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work assignments are varied..
Description The Senior Quality Assurance, Clinical Professional requires being both a nurse/RN and a certified Coder nurse as this position will be ... to ensure high accountability of compliance and..
... and more productive in their professional and personal lives. We encourage ... is committed to providing personalized, high-quality primary care combined with an ... and more productive in their..
Description Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional consults and collaborates with clinicians/nurses ... to ensure high accountability of compliance and quality and claims are being reviewed .....
Job Information Humana Senior Accreditation Professional in Dover Delaware Description The ... Delaware Description The Senior Accreditation Professional works in a team environment ... performing complex tasks related to compliance..
... Information Humana Medicaid Associate Director, Compliance Nursing in Dover Delaware Description ... Delaware Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
... they are receiving the best quality of care possible. You will ... communication with members Adhere to compliance standards, state and federal regulations ... individual licensing boards Participate in..