Compliance Nurse - Medicaid

HumanPanorama

Virginia, US
Base: $71,100 - $97,800 py; bonus/equity: not spec...
Hybrid
Active registered nurse license
Experience in mco environment
Proficiency in microsoft office
The Compliance Nurse reviews case management and utilization management activities to ensure adherence to regulations

Job Summary

  • The Compliance Nurse reviews case management and utilization management activities to ensure adherence to regulations.
  • This position involves auditing CM medical records for compliance and conducting audits/reports.
  • Humana offers competitive benefits that support whole-person well-being, including medical, dental, and retirement plans.

Matching Summary

The Compliance Nurse reviews case management and utilization management activities to ensure adherence to regulations.

Salary

Base: $71,100 - $97,800 per year; Bonus/Equity: Not specified; Benefits: Competitive benefits offered

Skills & Requirements

Must-have

  • Active Registered Nurse license
  • Experience in MCO environment
  • Proficiency in Microsoft Office

Nice-to-have

  • Health Plan experience
  • Previous Medicare/Medicaid experience
  • Exceptional communication skills

Key Requirements

  • Bachelor's degree
  • Minimum three years of nursing experience
  • Two years of audit experience

Work Rights

Must reside in Virginia or bordering state

Tailored Resume

Cover Letter