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Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
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 ..
... Required Qualifications Associates degree in Nursing Current, Active Registered Nurse (RN) ... Must have an active Compact nursing license PRIOR to applying for ... Council of State Boards of..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..
Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
JOB SUMMARY: Under the direction of the DON/ADON, the house supervisor performs clinical and administrative responsibilities for the facility during his/her assigned shift. Works as House Supervisor every other weekend. QUALIFICATIONS: ..
Description Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. ..
Description The Intern - Care Manager, Registered Nurse, RN performs varied activities moderately complex administrative/operational/member support and semi-routine assignments to support the Florida Medicaid team. Responsibilities The Intern - Care Manager, ..
... action. Hold an active Compact nursing license- must have prior to ... Council of State Boards of Nursing (NCSBN) developed the Nursing Licensure Compact (NLC), which is ... of..
Description The Care Manager, Telephonic Behavioral Health 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 ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Montpelier Vermont Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Job Information Humana Care Manager, Telephonic Nurse 2 - WAH Nationwide in Montpelier Vermont Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Genesis HealthCare is one of the leading providers of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how ..
Up to a $3,000 Sign on Bonus for full time! BenefitsHealth, Dental, Vision, Company-paid life insurance, 401K, Paid Time OffEmployee Assistance Program to support mental healthEmployee Foundation to financially assist through ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Montpelier Vermont Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The Nurse ..
Genesis HealthCare is a leading provider of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how care is ..
