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Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
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Description Reports directly to the Vice President, Medical Management Operations and serves as a member of the HGB Executive Committee. Leads functions related to HGB's Care Management programs to include predictive ..
... Information Humana Medicaid Associate Director, Compliance Nursing in Chicago Illinois Description The ... Illinois Description The Associate Director, Compliance Nursing reviews utilization management activities and ... and abuse. The..
... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate Director, Utilization Management Nursing requires a solid understanding of ... The Associate..
... seeking a Provider Claims Education Manager(Manager, Claims Research & Resolution) who ... accurately.. The Provider Claims Education Manager (Manager, Claims Research & Resolution) oversees ... this team, Provider Claims..
... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... in accordance with all legal, compliance, and regulatory requirements and programs. ... all requirements of the FMCNA..
... Nationwide Associate Director, Utilization Management Nursing in Chicago Illinois Description The ... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate..
The Team Manager is the leader of the Patient Care Team and that member of the team whose function is to: supervise, evaluate and coordinate the various component members of the ..
Job Information Humana Associate VP, Health Plan Quality Improvement and Performance in Chicago Illinois Description The Associate VP, strategically identifies, develops, and implements programs that influence providers, members or market leadership ..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
... Responsibilities Manage activities, workflow and nursing resources of assigned nursing unit(s). Ensure compliance with regulatory and accreditation requirements ... and other actions to ensure compliance with budget guidelines. Requirements..
... Kindred at Home RN Clinical Manager in Oak Brook Illinois The ... Oak Brook Illinois The Clinical Manager coordinates and oversees all direct ... to ensure documentation is in..
Genesis is one of the nation's 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 ..
Job Information Humana Associate VP, Quality Improvement in Chicago Illinois Description The AVP, Quality Improvement and Performance will develop, maintain, own and execute strategies to improve performance of the TRICARE contract ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Chicago Illinois Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
Description The Risk Adjustment Integrity Unit (RAIU) Associate Director works collaboratively across the enterprise, communicating both the story and impacts of the highly specialized and critical investigations the unit conducts. This ..
Description The Manager, Compliance Nursing reviews utilization management activities and ... fraud, waste, and abuse. The Manager, Compliance Nursing works within specific guidelines and ... schedules and goals. Responsibilities The..
Job Information Humana Regional VP, Operations IL Medicaid in Chicago Illinois Description Humana's Illinois Medicaid, Operations Officer (COO) will be responsible for the strategic development and oversight of operations for Humana's ..