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General Purpose: Provides effective and efficient patient care under the supervision of a registered nurse and in accordance with the patient’s plan of care, applicable law and regulation, accepted standards of ..
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Description The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Understands alternate payment structures and quality incentives for ..
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 Provider Quality Improvement Field RN ... Description The Senior Stars Improvement, Clinical Professional responsible for the development, ... Program. The Senior Stars Improvement, Clinical Professional work..
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 ..