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... Utilization Management Nurse utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization ... and most appropriate treatment, care..
... where the analysis of situations or data requires an in-depth evaluation ... coach assigned providers, providers groups and/or MSO groups on gap closing ... through in-person, virtual, telephone, email..
... and determine necessities to achieve and/or maintain optimal wellness. Work assignments ... monitoring patient care through assessments and/or evaluations. May create member care ... eligible to participate in SkillBridge,..
... and determine necessities to achieve and/or maintain optimal wellness. Work assignments ... monitoring patient care through assessments and/or evaluations. May create member care ... in the state of Florida..
The early bird gets the Worm!! Apply today!! **AdvisaCare Strives to Be YOUR First Choice for Employment!** ** Great Opportunity to start YOUR New Year with a Great Agency with Awesome ..
... needs and requirements to achieve and/or maintain optimal wellness state by ... monitoring patient care through assessments and/or evaluations. May create member care ... reside in an eNLC state..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Michigan Description The Supervisor, Pre-Authorization Nursing will be managing the team ... and policies, and approves services or..
Description The Manager, Compliance Nursing reviews utilization management activities and ... and abuse. The Manager, Compliance Nursing works within specific guidelines and ... goals. Responsibilities The Manager, Compliance Nursing ensures..
... Required Qualifications Associate's Degree in Nursing or higher Current US Registered Nurse ... interpreting medical records for coding or medical necessity Comprehensive understanding of ... Preferred Qualifications Certification from..
Job Information Humana Care Manager, Telephonic Nurse 2 - WAH Nationwide in Troy Michigan Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and ... and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed guidelines ... approach. Responsibilities The Supervisor, Compliance Nursing ensures..
... needs and requirements to achieve and/or maintain optimal wellness state by ... challenged by serious mental illness and/or substance use. Our goal is ... allow each member to achieve..
... Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization ... and most appropriate treatment, care..
... The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from ... NAL Care Manager, Telephonic Nurse Assistant 2 is knowledgeable about Humana ... that provides Humana members with..
... Minimum of Associate's Degree in Nursing Registered nurse with active Compact ... direct patient care (either medical or behavioral health) Adept experience working ... to provide a high-speed DSL..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for ... and policies, and approves services or forward requests to the appropriate ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing works..
... Telephonically assess Medicare, Medicaid, Commercial, and/or and Group Account members in ... needs and requirements to achieve and/or maintain optimal wellness state Guide ... Required Qualifications Associates degree in..
... dealing with end-stage renal failure or chronic kidney disease. Do you ... take place in a facility or a training clinic other than ... leverage a broad range of..
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. Responsibilities ..
