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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines ... you succeed, we succeed! The..
Description The Utilization Management Behavioral Health Professional 2 utilizes ... and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... courses of action. Responsibilities The Utilization Management..
Description The Care Manager, Telephonic Behavioral Health 2, in ... with resources appropriate for the care and wellbeing of members. The ... and wellbeing of members. The Care Manager, Telephonic..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral ... involves processing referrals into medical management system with emphasis on accuracy ... to answer provider/beneficiary inquiries. The Care Management..
Job Information Humana Telephonic Care Manager in Charleston West Virginia Description ... West Virginia Description The Telephonic Care Manager will be part of the ... of the Humana Military Case..
... associates, and possible participation in care management. The clinical scenarios predominantly arise ... predominantly arise from inpatient, post-acute care environments, outpatient service requests, ER ... on collaborative business relationships,..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is ... and monitoring of the Autism Care Demonstration (ACD) including coordination of ... and clinical compliance, and case management. Serve..
... Information Humana Nationwide Associate Director, Utilization Management Nursing in Charleston West Virginia ... Virginia Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills ... administration determinations. The..
The Case Manager ensures the collaborative process of ... case throughout stay to ensure utilization of services are in accordance ... in accordance with plan of care and minimize financial..
Job Information Humana Manager, Utilization Management RN - Remote in Charleston ... Charleston West Virginia Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... and/or benefit administration determinations...
... clinical case reviews of the care received by members in an ... around behavioral and physical integration, care modeling, best practice with behavioral ... will be responsible for Managing..
... relationships with Account / Clinical Management and PCO-IPU Operations teams. Responsibilities ... and process improvements. Conduct periodic utilization review of hospice IPU medications ... establish strategies for improving drug..
... requested services, requested level of care, and/or requested site of service ... associates, and possible participation in care management. The clinical scenarios predominantly arise ... arise from inpatient or..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Charleston ... Virginia Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible ... and monitoring of the Autism..
... any field Minimum 1 year Utilization Management such as, FER, Concurrent, Prior ... Prior Authorization Minimum 1 year Care Management and/or Care Coordination Exposure to Behavioral Health ... Work..
... prior authorization requests for appropriate care and setting, following guidelines and ... Reviews inventory reports and assists management with data tracking to identify ... medical necessity and level of..
Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid ... Charleston West Virginia Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... and/or benefit administration determinations...
Job Information Humana RN-Care Manager, Behavioral Health-RN in an eNLC ... Charleston West Virginia Description The Care Manager, Telephonic Behavioral Health 2, in ... with resources appropriate for the care..
... broad understanding of pharmacy, managed care, and specialty to develop and/or ... drug policy development and drug utilization management strategies Leads a team of ... medicine and total cost..
