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Constellis was established in 2010 by a group of operators and investors who sought to combine best-in-class brands, assets and people within the complex risk management industry. Today, the leading provider ..
... Medical Director. Regularly reviews integration performance, network adequacy, performance improvement projects, and surveys related to ... Shall work closely with the Performance/Quality Improvement Coordinator, Behavioral Health Network Director, .....
Description Humana Healthy Horizons in Louisiana is seeking a RN, Clinical Educator (Nursing Educator 2) who will plan, direct, coordinate, evaluate, develop, and/or deliver trainings and education programs for professional nursing, ..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management (Behavioral Health) who will utilize clinical skills to support the coordination, documentation, and communication of behavioral health services and/or ..
Description The Medicaid Housing Specialist (Care Management Support Professional 1)contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or ..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management Nursing who will utilize clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit ..
... is seeking a Manager, Quality Improvement who will implement and monitor ... will implement and monitor quality improvement program components, including annual program ... annual evaluation. The Manager, Quality..
Description The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for ..
