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Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
Description The Compliance (UM) Professional 2 conducts and summarizes compliance audits. The Compliance (UM) Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses ..
Job Information Humana Grievances & Appeals Representative 3 (FULLY BILINGUAL English/Spanish) Work at Home Florida ONLY in Key West Florida Description The Bilingual Grievances & Appeals Representative 3 manages client denials ..
Description The Bilingual Spanish/English Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional ..
