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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..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
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 ..
... 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,..
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 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 Medicare Appeals and Grievance Medical Director in Ridgeland Mississippi Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
... Information Humana Actuary, Risk and Compliance in Ridgeland Mississippi Description This ... within the Senior Products Actuarial Compliance team focused on special Medicare ... special programs, this role supports..
... 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..
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 ..
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 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 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 ..
Ridgeland office of a BCG Attorney Search Top Ranked Law Firm seeks labor and employment attorney with experience. The candidate will have the opportunity to take advantage of a well-developed national ..
Experienced Labor and Employment Attorney The candidate must have a self-sufficient book of portable business (ideally $400,000+) as well as a demonstrated drive and the potential for additional business generation. Must ..
Job Information Humana FP&A Lead, Medicaid Market in Ridgeland Mississippi Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
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 Medical Director - Medicare Pharmacy Appeals in Ridgeland Mississippi Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
