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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 Stars Improvement, Clinical Professional responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Stars Improvement, Clinical Professional work assignments are varied and frequently ..
Description The Utilization Management Nurse 1 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 1 work assignments ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
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 ..
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 ..
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 ..
Specialty: RN-Emergency Department -Travel Job Description ER nurses work as part of a team with physicians, other nurses and healthcare professionals to provide care, monitor health conditions, plan long-term care needs, ..
Specialty: RN-Med Surg -Travel Job Description Evaluates assigned patients and plans, implements and documents nursing care. Assists physicians during examinations and procedures. Performs various patient tests and administers medications within the ..
Specialty: RN-Medical Surgical -TravelJob Description Registered nurses in this specialty practice primarily on hospital units and care for adult patients who are acutely ill with a wide variety of medical problems ..
Description The Telephonic Nurse Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
Specialty: RN-ICU/CCU -TravelJob Description Assist physicians with patient management Provide patient care to the critically ill Collaborate with other disciplines to ensure effective and efficient patient careQualifications and Job Info 1-2 ..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the flexibility ..
Job Information Humana Senior Medical/Financial Risk Clinical Professional in Brentwood Tennessee Description The Senior Medical/Financial Risk Clinical Professional is responsible for supporting the development, implementation and monitoring of medical/financial risk. The ..
