THE LARGEST COLLECTION OF JOBS ON EARTH
Supports PDF, DOC, DOCX, TXT, XLS, WPD, HTM, HTML files up to 5 MB
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 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 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 ..
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 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 ..
Job Information Humana ISNP Engagement Executive - Wisconsin in Green Bay Wisconsin Description Are you passionate about the Medicare population? Are you looking for an opportunity to directly help impact the ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Green Bay Wisconsin Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Green Bay Wisconsin Description The Fraud and Waste Professional 2 conducts investigations of allegations ..
Job Information Humana UM Medical Director - Conviva in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Job Information Humana FP&A Lead, Medicaid Market in Green Bay Wisconsin Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
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 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 Medicare Appeals and Grievance Medical Director in Green Bay Wisconsin Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
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 Green Bay Wisconsin Description The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent ..
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 ..
... contract requirements, provide research and regulatory interpretation, perform auditing and monitoring, ... will: Interpret and define Medicaid regulatory and contract requirements to be ... be used to evidence meeting..
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 ..
WalgreensnJob DescriptionOpens and closes the store in the absence of store management, including all required systems start-ups, required cash handling, and ensuring the floor and stock room are ready for the ..