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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 ..
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Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
Job Information Humana Senior Clinical Recruiter in Troy Michigan Description The Senior Clinical Recruiter recruits qualified applicants for staff nurse or other positions requiring registered nurse licensure, licensed practical nurse, or ..
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 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 ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Troy Michigan Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
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 ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
1317 W Main St,Fremont,Michigan,49412,United States of America DaVita is seeking a Registered Nurse who is looking to give life in an outpatient dialysis center. You can make an exceptional difference in ..
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 ..
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 The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Job Information Humana Clinical Auditor Registered Nurse Care Management or Utilization Management in Troy Michigan Description Humana Healthy Horizons in Ohio is seeking a Utilization and Case Management Clinical Auditors. This ..
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 ..
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 ..
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 ..
Job Information Humana Senior Medical/Financial Risk Clinical Professional in Troy Michigan Description The Senior Medical/Financial Risk Clinical Professional is responsible for supporting the development, implementation and monitoring of medical/financial risk. The ..
Description Please note that this role requires you to work 4 days a week (including Saturday and Sunday), 10 hours a day, from your home office. If you cannot accommodate this ..
Job Information Humana VP, Clinical Operations in Troy Michigan Description VP, Clinical Operations and Chief Clinical Officer of Kindred at Home, you will be responsible for planning and creating the ongoing ..
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 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 ..
