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Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Job Information Humana Grievances & Appeals Representative 3 (Fully Bilingual English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Grievances & Appeals Representative 3 manages client medical denials by ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
... Inbound Contacts Representative 2 (Fully Bilingual in English/Spanish) in San Juan ... medical, dental & vision benefits, case management, compliance requirements and more. ... performed for English and or..
Job Information Humana Grievances & Appeals Representative 3 (Bilingual English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Grievances & Appeals Representative 3 manages client medical denials by conducting ..
Description Do you enjoy helping those in need? Do you love researching, analyzing medical documents to determine if something was missed? Have you ever considered yourself a detective for medical claims ..
Job Information Humana Call Quality Professional 1 (Bilingual English/Spanish) in San Juan Puerto Rico Description The Call Quality Professional 1 monitors and evaluates the quality of inbound and/or outbound customer service ..
Job Information Humana Call Quality Professional 2 in San Juan Puerto Rico Description The Call Quality Professional 2 monitors and evaluates the quality of inbound and/or outbound customer service calls, call ..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
