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Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review of ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that ... to support optimal reimbursement. The Nurse Auditor 2 work assignments are ... Humana is looking for a..
... Information Humana Care Manager, Telephonic Nurse 2 Certified Diabetes Care and ... bridge the gap and integrate clinical and self-management aspects of diabetes ... Humana is seeking a Registered..
... Information Humana Care Manager, Telephonic Nurse 2-Remote (Eastern Standard Time) in ... Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, ... members. The Care Manager, Telephonic..
Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
... reviews for requested services using clinical judgment and refers to internal ... processes. Enters and maintains pertinent clinical information in various medical management ... policies. Required Qualifications Active Registered..
Description The RN Clinical team is looking for a ... looking for a dynamic Registered Nurse to join the team working ... will be someone who applies clinical and coding..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... administration determinations. The Utilization Management Nurse 2 work assignments are varied ... action. Responsibilities The Utilization..
... care management. The CMSS provides non-clinical support to the assessment and ... assignments. CMSS's work collaboratively with clinical support associates, (including nurses and ... customers (members), business partners, and..
... uses advanced data analytic techniques, clinical acumen and operational insights to ... work at home anywhere Humana's Clinical Analytics and Trend (CAT) team ... needs your healthcare, analytic, and..
Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for ... without direction. Responsibilities Senior Pre-Authorization Nurse: Serves as a team lead ... with questions and mentoring of clinical staff..