- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality...past 3 years + Experience as a Utilization Management Auditor + Health Plan experience working with large carriers… more
- Molina Healthcare (Madison, WI)
- …Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist, Quality Interventions/ QI … more
- CVS Health (Madison, WI)
- …and external partners. Ability to travel for business needs. **Preferred Qualifications:** Registered Nurse ( RN ) Previous leadership experience. AAPC Coding ... CPC's, working closely with internal and external stakeholders and ensuring compliance with regulatory requirements. The Manager develops strategies to manage… more