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Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
Job Information Humana Clinical Vendor Management Lead - Remote, ... in Naples Florida Description The Clinical Vendor Management Lead works as ... Vendor Management Lead works as clinical liaison between..
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 ..
Description CarePlus is seeking a Clinical Business Lead who will lead ... Management and Utilization Management. The Clinical Business Lead works on problems ... moderate to substantial. Responsibilities The Clinical..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Job Information Humana Director, Care Delivery and EMR/EHR Technology in Naples Florida Description The Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives specific to ..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care ..
Assistant General Counsel, Home Solutions Duties: Provide strategic advice and counsel on operational and regulatory matters, as well as guidance on issues arising in the day-to-day functionality of Humana’s Home Solutions ..
