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Assistant General Counsel Duties: Monitor and assists in the management of legal affairs with the assistance of outside counsel as necessary; Monitor progress of work being done by outside counsel, including ..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately ... for well-being Responsibilities The Senior..
Description The Quality Assurance, Clinical Professional 2 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work assignments are varied and ..
Description The Compliance Nurse 2 reviews utilization management ... fraud, waste, and abuse. The Compliance Nurse 2 work assignments are ... appropriate courses of action. The Compliance Nurse 2 will..
... 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,..
Description The Senior Quality Assurance, Clinical Professional requires being both a nurse/RN and a certified Coder nurse as this position will be cross trained to review DRG (Diagnosis Related Group) audits ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities ... fraud, waste, and abuse. The Compliance Nurse work assignments are varied ... schedule and overtime. Responsibilities The..
... Enterprise Risk Management, business units, regulatory agencies, and industry groups to ... risks are effectively managed and compliance objectives are achieved. In addition, ... in ensuring Humana's risk and..
Assistant General Counsel, Home Solutions Duties: Provide strategic advice and counsel on operational and regulatory matters, as well as guidance on issues arising in the day-to-day functionality of Humana’s Home Solutions ..
Description The Manager, 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 Manager, Compliance ..
Description The Compliance Lead (SNP) ensures compliance with governmental requirements. The Compliance Lead works on problems of ... moderate to substantial. Responsibilities The Compliance Lead (SNP) develops and implements .....
Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities Seeking Senior..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Dover Delaware Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to lead ..
Job Information Humana Compliance (UM) Coordinator 2 in Dover ... in Dover Delaware Description The Compliance (UM) Coordinator 2 conducts and ... Coordinator 2 conducts and summarizes compliance audits. The..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Dover Delaware Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can ..
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 Care Manager, Telephonic Registered Nurse, (RN) 2 in Dover Delaware Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and ..
POSITION FEATURES:*12 weeks of PAID training, no experience required*Competitive pay*Pay increase when certified (required within 18 months)*No Sundays, e/o Saturday*Tuition reimbursementDescriptionProvide your personal attention and kindness, professional insight, and a generosity ..
Job Information Humana Manager, Compliance - Agent Investigation Unit in ... Dover Delaware Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, ... with governmental requirements. The Manager,..
