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Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
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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 ..
Description ** Role is open to remote/virtual/home office post-covid. Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do ..
... whose purpose is to provide care management program support resources to ... careers. At Partners in Primary Care, we're seeking innovative people who ... whole. Responsibilities CenterWell Senior Primary..
... and/or vendors to close HEDIS care gaps. The Senior Stars Clinical ... and/or vendors to close HEDIS care gaps. The work is primarily ... providers and/or vendors to close..
Description The UM Specialist contributes to administration of utilization management. The UM Specialist performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. Responsibilities Humana's ..
Description Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional consults and collaborates with clinicians/nurses to ensure high accountability of compliance and quality and claims are being reviewed correctly. This position ..
Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Senior Stars Improvement, Clinical Professional work assignments involve moderately ..
Description The Transplant Care Manager, Telephonic Nurse 2 , ... with resources appropriate for the care and wellbeing of members. The ... wellbeing of members. The Transplant Care Manager, Telephonic..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
... best and most appropriate treatment, care or services for members at ... acute rehab and long term care hospital level of care. Coordinates and communicates with providers, ... other..
Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied ..
Description The Inbound Contacts Representative 1 (Go365 Calls Rep) represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs operational/customer support/computational tasks. Typically works ..
Description The Manager, Care Management leads teams of nurses ... behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines ... succeed, we succeed! The..
Description The Care Manager, Telephonic Nurse 2 , ... with resources appropriate for the care and wellbeing of members. The ... and wellbeing of members. The Care Manager, Telephonic Nurse..
