Compliance Nurse 2 Position Available In [Unknown county], Florida

Compliance Nurse 2
Available in 7 locations
Available in 7 locations

Remote Job:

Remote Job:

Yes
widget:
Full time

Category:

Nursing
undefined:
Conviva Senior Primary Care

Job ID:

R-373965

Description
Be a part of our caringmunity and help us put health first
The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adnce to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Compliance Nurse 2 ensures mandatory reportingpleted. Conducts and summarizespliance audits. Collects and analyzes data daily, weekly, monthly or as needed to assess oue and operational metrics for the team and individuals. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance w needed. Follows established guidelines/procedures.
Use your skills to make an impact
Required Qualifications
Bachelor’s degree in nursing (BSN)
A minimum of three years varied nursing experience
Active RN license in the state(s) in which the nurse is required to practice
Ability to be licensed in multiple states without restrictions
Preferred Qualifications
Minimum of 3 years of Compliance Nursing
Clinical documentation improvement (CDI) knowledge
Health Plan experience working with large carriers
Previous Medicare/Medicaid experience a plus
Previous experience in chronic disease management, utilization management, case management, discharge planning and/or home health or rehab
Previous experience working in/with the primary care setting
Risk adjustment experience
Auditing experience
Coding background
Ability to work independently under general instructions and with a team
Must be passionate about contributing to an organization focused on continuously improving patient experiences
Strongmunication skills
Proficient with Microsoft Office products including Word, Excel and Outlook
Additional Information
This position is 100% remote; expectation at minimum one team meeting with travel required.
Hours are generally M-F 8-5; flexibility upon request to manager

Travel:

While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
Thepensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 – $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based uponpany and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offerspetitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off,pany and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us

About Conviva Senior Primary Care:

Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients’ well-being.
About CenterWell, a

Humanapany:

CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (

NYSE:

HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who aremitted to putting health first – for our teammates, patients,munities andpany. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
​
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, inpliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms ofpensation and selection for training, including apprenticeship, at all levels of employment.
Request an Amodation
If you are an individual with a disability and require a reasonable amodation toplete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for ing, you may contact ADAhumana for assistance.
Employment Fraud Notice
Humana will never ask a candidate for money for work equipment and network access or request access to personal accounts during the application process. Learn more about identifying and preventing employment fraud or report a suspected employment fraud case.
California Resident Applicants
If you are a California resident ing for a position and would like to review our California Applicant Privacy Policy, click : CA Resident Applicant Privacy Policy
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And when you work , you feel it. It’s how you grow. It’s how you’re weed into the associatemunity. It’s what guides us in putting health first. And it forms the connection each of us have for the people we serve.
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