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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 ..
... to obtain desired productivity and clinical outcomes for all care management ... researching and the development of clinical practice guidelines and to ensure ... team to ensure technology supports..
... interaction with beneficiaries to address clinical conditions identified through Predictive Analytics ... medical care and achieve desired clinical outcomes. As part of the ... will serve as the primary..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Job ID 21000GNRAvailable Openings 1Position Specific Information This position will cover the following clinics in the Springfield, Massachusetts area: Pioneer Valley Dialysis, Western Mass Kidney Center, East Springfield Dialysis, Palmer Dialysis, ..
Description The Care Manager, Telephonic Nurse 2 , 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 ID 21000D3DAvailable Openings 1Position Specific Information $5000 Sign on Bonus!PURPOSE AND SCOPE: Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing ..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
... unrestricted license to include: Licensed Clinical Social Worker (LCSW), Licensed Masters ... Licensed Masters Social Worker (LMSW-ACP), Clinical Psychologist with; Clinical experience in: pediatrics, behavioral health, ... of 1..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
... health care and achieve desired clinical outcomes. As part of the ... will serve as the primary coordinator and point of contact for ... for all activities within the..
... complexity. Responsibilities The Care Coach Coordinator employs a variety of strategies, ... some interpretation. The Care Coach Coordinator assesses and evaluates member's needs ... Required Qualifications The Care Coach..
Description The UM Administration Coordinator contributes to administration of utilization ... utilization management. The UM Administration Coordinator performs varied activities and moderately ... semi-routine assignments. The UM Administration Coordinator is..
