Regulatory Policy Specialist Jobs in Colorado Springs

Regulatory Compliance Specialist IV The candidate manages an ... existing audit compliance efforts and regulatory compliance obligations, and to support ... in alignment with industry and regulatory requirements and expectations...

Regulatory Compliance Specialist IV The candidate assists and ... requirements of government regulations and/or regulatory agencies. Performs evaluation of internal ... of documentation as related to regulatory compliance and recommends..

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 ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial. This role will focus on Humana's ..

Job Information Humana FP&A Lead, Medicaid Market in Colorado Springs Colorado Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..

... needs, SOPs, processes and other regulatory or company directives are adhered ... investigation and ensure documentation of regulatory deficiencies. Determine the need for ... investigation and ensure documentation of..

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 Supervisor, 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 Supervisor, Compliance ..

Description The Lead, IT Compliance assesses 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 Medical Director - Medicare Pharmacy Appeals in Colorado Springs Colorado Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..

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 Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Colorado Springs Colorado Description The Fraud and Waste Professional 2 conducts investigations of allegations ..

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 ..

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 Colorado Springs Colorado Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..

Job Information Humana UM Medical Director - Conviva in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..

Job DescriptionAssists the Team Leader in all aspects of daily operations including profitability, expense control, buying, merchandising, labor, regulatory compliance and special projects as assigned. Leads and develops Team Members. All ..

Description The Compliance Lead (SNP) ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities The Compliance Lead (SNP) ..

Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Humana, we want to help people everywhere, ..

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 ..

Job Information Humana Pharmacy Special Investigations Professional (Fraud, Waste & Abuse) Remote in US in Colorado Springs Colorado Description The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent ..

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 ..

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 ..