- Humana (Salem, OR)
- …part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to ... to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently...skills to make an impact** **Required Qualifications** + Active Registered Nurse license in a state that is part… more
- Humana (Salem, OR)
- …to assess outcome and metrics of market compliance with NCQA must pass UM elements. + ** Audit Calibration:** Verify findings to maintain data quality and ... Role:** Serve as key advisors to market management on compliance -related matters related to audit findings. +...Peer Review Literature, etc. + Working knowledge of NCQA UM letter requirements and compliance best practices.… more