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... and commercial carriers, including managed care and other market forces on ... other market forces on health care delivery. They ensure that their ... quality and efficient delivery of..
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... as a Pulmonary Fibrosis Foundation Care Center Network, as a Scleroderma ... to ensure coordination of patient care across the continuum . EEO/AA/Disability/Veteran ... of best practices, standards of..
Description The WEEKEND Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization ..
... Ensure provision of quality patient care while maintaining cost-effective clinical operations ... Compliance Program, and FMS patient care and administrative policies as the ... decisions to ensure continuity of..
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 ..
PURPOSE AND SCOPE:Supports the training and education of employees based in company facilities and programs within an assigned geographical area. Delivers standardized, competency based, training and development programs including new employee ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Bridgeport Connecticut Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
... to ensure coordination of patient care across the continuum. EEO/AA/Disability/Veteran Responsibilities ... of best practices, standards of care, benchmarks, and evidence-based treatment guidelines ... medical team, provides continuity of..
... platforms, and progressive approaches to care drive Humana Military to be ... Post Discharge Call (PDC) Telephonic Care Manager will be part of ... part of the Humana Military..
Job Information Humana Care Manager, Telephonic Nurse 2 - ... in Bridgeport Connecticut Description The Care Manager, Telephonic Nurse 2 , ... with resources appropriate for the care and wellbeing..
... experience with requests for appropriate care and setting(s), guidelines and policies ... necessity review and level of care review for requested services. Educate ... address the BH levels of..
Description The Care Coach 1 assesses and evaluates member's ... with resources appropriate for the care and wellbeing of members. The ... and wellbeing of members. The Care Coach 1..
Description The Director, Health Services Nursing serves as the strategic leader for Humana Behavioral Health Utilization Management Inpatient services - including all clinical (inpatient and some OP medical necessity oversight ) ..
Description The Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization Behavioral ..