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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 Director, Internal Audit develops, plans and evaluates internal audit programs for the organization's accounting and statistical records and the activities of various departments to ensure compliance with the organization's ..
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 ..
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..
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..
Description The Internal Audit Associate Director is part of the senior leadership team within Internal Audit Consulting Group (IACG) and supports the strategic initiatives of the department and the management of ..
... 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..
Job Information Humana Quality Audit Professional 2 (Grievance & Appeals) -Remote, anywhere with-in Eastern Time Zone in Louisville Kentucky Description The Quality (Non-Calls) Professional 2 ensures that products meet specific Centers ..
Job Information Humana Clinical Auditor Registered Nurse Care Management or ... is completed. Conducts and summarizes compliance audits. Responsibilities The Clinical Auditor for the Care and or ... physician office,..
... 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 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..
... the Company's Section 404 (SOX) compliance efforts, including General IT controls. ... of the organization to ensure compliance with the organization's policies, procedures ... to execute on Sarbanes-Oxley (SOX)..
Job Information Humana Senior Compliance Registered Nurse in Louisville Kentucky ... Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory ... timely and accurately. Responsibilities Senior Compliance Nurse..
Job Information Humana Bilingual Quality Auditor in Louisville Kentucky Description The ... Kentucky Description The Bilingual Quality Auditor/ Professional 2 ensures that products ... ensure accuracy. Responsibilities Bilingual Quality Auditor/..
Job Information Humana Manager, Compliance - Agent Investigation Unit in ... Louisville Kentucky Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, ... with governmental requirements. The Manager,..
... 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..
... and Advisory Services. The Coding Auditor ensures that coding compliance initiatives are met for our ... and other factors. The Coding Auditor will have the following responsibilities: ... following..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Kentucky Description The Medical Coding Auditor reviews medical claims submitted against ... CPT, HCPCS). The Medical Coding Auditor..
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 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 Bilingual Senior Compliance Professional - Agent Investigations Unit ... Agent Investigations Unit (AIU) ensures compliance with governmental requirements, specifically those ... Humana plans. The AIU Senior Compliance Professional..
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 ..
Job Information Humana Quality Audit Professional 2 (Grievance & Appeals) -(FULLY BILINGUAL English/Spanish) Remote, anywhere with-in Eastern Time Zone in Louisville Kentucky Description The Quality (Non-Calls) Professional 2 ensures that products ..