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Description This role is on the Humana At Home Special Needs Plan Compliance Review team within Home Solutions Compliance and Risk Management. The Quality Assurance Professional 2 performs audits to establish ..
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 .....
... seeking a Software Entitlement and Compliance Specialist who will be accountable for ... including full software lifecycle management, compliance, optimization, audit data requests and ... Software Asset Management Entitlement..
... business areas to drive operational compliance. Humana is seeking a Risk ... will drive operational excellence, advance compliance results, and confirm audit readiness ... with business areas, Market leaders,..
Job Information Humana Medicare Appeals and Grievance Medical Director in Billings Montana Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Description Introduction The 3rd Party Segment Lead will execute and lead a team of risk professionals in conducting cyber and regulatory-driven assessments and oversight of key 3rd Parties across designated business ..
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 ..
Job Information Humana UM Medical Director - Conviva in Billings Montana Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana FP&A Lead, Medicaid Market in Billings Montana Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description The Lead, IT Compliance assesses the most complex new ... systems procedures follow corporate standards, regulatory requirements, and best practice frameworks. ... practice frameworks. The Lead, IT Compliance works..
Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..
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 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 ..
... seeking a Software Entitlement and Compliance Specialist who will be accountable for ... including full software lifecycle management, compliance, optimization, audit data requests and ... where the Software Entitlement..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Billings Montana Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
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..
Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of ... & Analytics to ensure continued compliance through innovative product offerings and ... and..
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 ..
... Information Humana Actuary, Risk and Compliance in Billings Montana Description This ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
