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Description The Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
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Job Information Humana Medicaid Associate Director, Compliance Nursing in Anchorage Alaska Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... Government. Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will..
Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary. The PDC Care Manager will assist beneficiaries as they ... Military TRICARE - PDC Care..
Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Anchorage Alaska Description Humana is seeking an experienced management professional to lead an interactive multidisciplinary team that helps translate the clinical ..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
Description The Manager, Fraud and Waste, Genetic Counseling provides clinical support for investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works within specific guidelines ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Anchorage Alaska Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..
Overview This position provides supervision and support of clinical operations, staff, and patients. Manages finances and personnel to ensure appropriate allocation of resources in providing quality patient care. Relocation, Commitment Bonus ..
... a Registered Nurse (RN) Clinical Manager (5 North Medical Oncology, Day-Shift, ... judgement to implement plans for operations in areas of responsibility LEADERSHIP: ... to improve existing systems or..
Job Information Humana Manager, Fraud and Waste-Remote US in ... in Anchorage Alaska Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
**Providence is calling a Registered Nurse (RN) Manager -** **Long Term Care (Nursing Administration, Day Shift, 1.0 FTE) to Providence Extended Care in Anchorage, Alaska.** **We are a community of caregivers ..
... behavioral health care strategy and/or operations. The Behavioral Health Medical Director ... and clinical guidance for Medical Operations and Market Operations Develop comprehensive care programs for ... programmatic requirements..
... / Clinical Management and PCO-IPU Operations teams. Responsibilities Location: Remote USA, ... for IPU services. Engage with operations to promote system, labor, and ... other internal teams surrounding IPU..
**Providence is calling a Team Manager Nurse Family Partnership (Home Health Care Nursing Partnership, Day Shift, 1.0 FTE) to Providence Home Health Care in Anchorage, Alaska.** **We are a community of ..
