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 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 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 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 Job Description Summary 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 ..
Job Information Humana UM Medical Director - Conviva in Montpelier Vermont Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
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 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 ..
... 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 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 ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Montpelier Vermont Description The Fraud and Waste Professional 2 conducts investigations of allegations of ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Montpelier Vermont Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Job Information Humana Pharmacy Special Investigations Professional (Fraud, Waste & Abuse) Remote in US in Montpelier Vermont Description The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and ..
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 ..
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 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 ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Montpelier Vermont Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
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 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 ..
Job Information Humana FP&A Lead, Medicaid Market in Montpelier Vermont 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 and existing information systems applications to ensure that appropriate controls exist, that processing is efficient and accurate, and that information systems ..