Regulatory Coordinator Jobs

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 ..

Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..

Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..

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 UM Medical Director - Conviva in Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..

Description The IT Compliance Professional audits the most complex new and existing information systems applications to ensure that appropriate controls exist, that processing is efficient and accurate, and that information systems ..

Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Dover Delaware Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the ..

... Professional creates awareness of current regulatory issues and ensures compliance of ... as follows: Monitor and analyze regulatory requirements to assess contract language ... initiatives, administrative practices, and applicable..

Job Information Humana Telephonic Care Manager in Dover Delaware Description The Telephonic Care Manager will be part of the Humana Military Case Management team; providing a comprehensive, holistic approach for Behavioral ..

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 ..

Immigration Paralegal (Remote) Date: Dec 17, 2022 Location: Remote, US Company: Under Armour Under Armour has one mission: to make you better. We have a commitment to innovation that lies at ..

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 ..

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 ..

Job ID 21000GDAAvailable Openings 1 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of ..

Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..

Description The Associate VP, Network Engineering will design, develop, execute and operate Humana's next generation Network infrastructure capability. This position will provide executive leadership to a team of 50 FTEs and ..

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 ..

Description The Provider NetworkSenior Network Operations Professional works with the Network Operations lead to oversee the plan's strategic opportunity for growth, audit/survey analysis, action plan oversight, implementation and coordination, provider services ..

Description Humana's technology environment has pivoted from a centralized model over the last several years to a more federated model. This trend will continue and accelerate to the point where Humana's ..

Description The Associate Director, Cloud Network Architecture will design, provide vision and strategy, develop, and execute Humana's Cloud Network architecture and environments. This is a management and leadership position that will ..

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 Compliance (UM) Coordinator 2 in Dover Delaware Description The Compliance (UM) Coordinator 2 conducts and summarizes compliance audits. The Compliance (UM) Coordinator 2 performs varied activities and moderately ..