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... advocate environment focused on high quality outcomes versus activities. Our department primarily ... of their care. We value quality work as every action taken ... the member and avoid..
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 ..
... is committed to providing personalized, high-quality primary care combined with an ... improve and support program production, quality and financial targets Assist in ... to obtain desired productivity and..
... for self-care to enhance their quality of life and achieve desired ... of life and achieve desired clinical outcomes. As part of the Case ... primary point of contact..
... Health Medical Director will provide clinical oversight to Behavioral Health (BH) ... Behavioral Health (BH) administrative and clinical programs for TRICARE beneficiaries. They ... population health management, contract compliance,..
... accordance with accepted standards of clinical practice to facilitate problem resolution ... achieve individualized patient goals and outcomes. Confer with the RN Supervisor ... Maintain contact with patients, physicians,..
... with the delivery of high quality care while achieving positive clinical outcomes, and patient/resident, family and employee ... to ensure the best possible outcomes for patients on assigned nursing..
Description Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..
... with questions and mentoring of clinical staff Reviews and resolves escalated ... Makes recommendations regarding training, improving outcomes, and process efficiencies. Completes medical ... reviews for requested services using..
... positive adjustment, rehabilitation and improved quality of life for our patients. ... and family to ensure comprehensive quality care of our patients. Supports ... Care (FKC) commitment to the..
... Member Plan (EFMP), auditing for quality and clinical compliance, and case management. Serve ... documentation. Complete required audits of clinical records. Assist in entry and ... compliance with ACD...
... strived to create better health outcomes and simplified experiences for millions ... and other military healthcare programs. High-quality service, cost-effective platforms, and progressive ... capacity for self-care to enhance..
... strived to create better health outcomes and simplified experiences for millions ... and other military healthcare programs. High-quality service, cost-effective platforms, and progressive ... interaction with beneficiaries to address..
LICENSED CLINICAL SOCIAL WORKER - LCSW Job ... adult patients a more positive quality of life we encourage you ... and response to treatment to Clinical Manager and the physician..
... self-care, to cost-effectively achieve desired clinical outcomes and to enhance quality of medical care. The case ... will serve as the primary coordinator and point of contact for .....
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 ..
... and available resources to promote quality, cost-effective outcomes. Coordinate medical, behavioral and other ... unrestricted license to include: Licensed Clinical Social Worker (LCSW), Licensed Masters ... Licensed Masters Social..
... Humana Nationwide Medicaid Behavioral Health Quality Lead in Portland Maine Description ... Maine Description The Behavioral Health Quality Lead will report directly to ... directly to the National Medicaid..
... interaction with beneficiaries to address clinical conditions identified through Predictive Analytics ... capacity for self-care to enhance quality of medical care and achieve ... medical care and achieve desired..
Job Information Humana Director, Informatics in Portland Maine Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..
