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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 ..
... and other members of the healthcare team to interpret, adjust, and ... requirements. PRINCIPAL DUTIES AND RESPONSIBILITIES: General and Staff Related: Provide day ... Recommend disciplinary action to Clinical..
Description Humana Healthy Horizons in Ohio is seeking a Care Guide/Care Guide Plus (Care Coach 1) who will assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness ..
Description Humana Healthy Horizons is seeking a Pre-Authorization Nurse 1 who will review prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forwards requests ..
Description Humana Healthy Horizons in Ohio is seeking Managers of Care Management (Physical Health & Behavioral Health) who will lead our physical or behavioral health care management operations and staff to ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
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 ..
