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Description The WEEKEND Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization ..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
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Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in San Juan Puerto Rico Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic ... members. The Care Manager, Telephonic Nurse 2 work assignments are varied ... take charge of their own healthcare..
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 ..
PURPOSE AND SCOPE:Supports the training and education of employees based in company facilities and programs within an assigned geographical area. Delivers standardized, competency based, training and development programs including new employee ..
... the global leader in dialysis healthcare we know what it takes ... to succeed with a premier healthcare organization. As a key member ... team as a Staff Registered..
... the global leader in dialysis healthcare, we know what it takes ... community outreach programs. Staff Registered Nurse This is an exceptional opportunity ... to succeed with a premier..
... Intern - Care Manager, Registered Nurse, RN performs varied activities moderately ... Intern - Care Manager, Registered Nurse, RN, will utilize Humana's Florida ... action. The Care Manager, Telephonic..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... their home. We are a..
Job Information Humana RN Manager, Care Management/HMS (FULLY BILINGUAL English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Manager, Care Management leads teams of nurses and behavior health professionals ..
... recruits qualified applicants for staff nurse or other positions requiring registered ... or other positions requiring registered nurse licensure, licensed practical nurse, or graduate nurse positions. Investigates sources and..
... and other members of the healthcare team to interpret, adjust, and ... of patient information. Coordinate Charge Nurse duties with Staff RNs acting ... the Technical Services Manual. Complete..
... looking for a dynamic Registered Nurse to join the team working ... overpayments when they happen. The Nurse Auditor 2 validates and interprets ... Qualifications Associate's Degree Active Registered..
