Compliance Nurse, Manager
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Job Description
Manager, Compliance Nurse at Humana overseeing compliance in healthcare utilization management. Ensuring policy adherence and improving associate and member outcomes through innovative processes.
Responsibilities:
- Review utilization management activities and documentation to ensure adherence to policies, procedures, and regulations
- Maintain NCQA accreditation and state contractual requirements
- Ensure team meets all assigned work completion and submission deadlines
- Align procedures to improve associate productivity and quality
- Improve associate experience and member outcomes
Requirements:
- Active Licensed Registered Nurse (RN) in your state of residence without disciplinary action
- 2+ years of compliance experience
- 2 years team lead, coaching, subject matter expert, and/or project leadership experience
- 1 year of Utilization Management experience
- Proficiency using Microsoft Office Word, Excel, PowerPoint
Benefits:
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
- many other opportunities
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