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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
Description The Senior IT Compliance Professional audits the most complex ... information systems procedures are in compliance with corporate standards. The Senior ... corporate standards. The Senior IT Compliance Professional..
Description The Lead, IT Compliance audits the most complex new ... information systems procedures are in compliance with corporate standards. The Lead, ... corporate standards. The Lead, IT Compliance works..
Job Information Humana Quality Audit Professional 2 (Grievance & Appeals) -Remote, anywhere with-in Eastern Time Zone in Birmingham Alabama Description The Quality (Non-Calls) Professional 2 ensures that products meet specific Centers ..
Job Information Humana Senior IT Compliance Professional- Controls Management (Remote / ... for a talented risk and compliance expert to help build a ... IT leaders to ensure Humana's compliance..
Job Information Humana Manager, Compliance - Agent Investigation Unit in ... Birmingham Alabama Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, ... with governmental requirements. The Manager,..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Alabama Description The Medical Coding Auditor reviews medical claims submitted against ... CPT, HCPCS). The Medical Coding Auditor..
... control environment. Responsibilities The IT Compliance Professional 2 works with all ... information systems procedures are in compliance with industry and corporate standards. ... of IT Risk Governance and..
Job Information Humana Quality Audit Professional 2 (Grievance & Appeals) -(FULLY BILINGUAL English/Spanish) Remote, anywhere with-in Eastern Time Zone in Birmingham Alabama Description The Quality (Non-Calls) Professional 2 ensures that products ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and well-being ..
Description The Claims Quality Audit Representative 3 audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. The Claims Quality Audit Representative 3 performs advanced administrative/operational/customer ..
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 The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g. CPT) to patient records. The Medical Coding Auditor ..
Internal Reference Number: R1016725 Summary Responsible for completing cost report reopenings within established timeframes and ensuring that the quality of our work meets CMS expectations. Reopenings include review of various provider ..
... Marketing Operations team, the QA Auditor reviews marketing communications for accuracy ... the accuracy review , the auditor uses proof reading skills and ... the adherence review , the..
... of the Senior IT Internal Auditor includes these and more! The ... more! The Senior IT Internal Auditor develops, directs, plans and evaluates ... and related procedures to ensure..
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 Senior Risk Management Professional identifies and analyzes potential sources of loss to minimize risk. The Senior Risk Management Professional work assignments involve moderately complex to complex issues where the ..
Description The DRG Validation Auditor extracts clinical information from a ... patient records. The Medical Coding Auditor work assignments are varied and ... action. Responsibilities The DRG Validation Auditor confirms..
Description The Quality Assurance, Clinical Professional 2 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work assignments are varied and ..