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Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the ..
Job Information Humana Senior Clinical Recruiter in Ridgeland Mississippi Description The Senior Clinical Recruiter recruits qualified applicants for staff nurse or other positions requiring registered nurse licensure, licensed practical nurse, or ..
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Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of ..
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 for Humana's Kentucky Medicaid Plan. The Utilization ..
Description The Weekend Telephonic 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 ..
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. Responsibilities The Utilization Management Nurse 2/Home Health ..
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 ..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the flexibility ..
Description The Utilization Management Nurse 1 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 1 work assignments ..
Job Information Humana Senior Medical/Financial Risk Clinical Professional in Ridgeland Mississippi Description The Senior Medical/Financial Risk Clinical Professional is responsible for supporting the development, implementation and monitoring of medical/financial risk. The ..
PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision ..
Description The Intern - Care Manager, Registered Nurse, RN performs varied activities moderately complex administrative/operational/member support and semi-routine assignments to support the business needs. Responsibilities The Intern - Care Manager, Registered ..
Job Information Humana Nurse Advice Line Telephonic Nurse - RN Compact License States Only in Ridgeland Mississippi Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and ..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..
Job Information Humana VP, Clinical Operations in Ridgeland Mississippi Description VP, Clinical Operations and Chief Clinical Officer of Kindred at Home, you will be responsible for planning and creating the ongoing ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Ridgeland Mississippi Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The Nurse ..
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 The Behavioral Health Care Manager, Telephonic Nurse, 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 ..
Description Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. ..
Description The Clinical Applications Trainer (aka Senior Technology Sales Professional) promotes and sells a portfolio of technical products and/or services and solutions directly to current and new end customers. The Senior ..
