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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 ..
... 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..
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... Information Humana Medicaid Associate Director, Compliance Nursing in Dover Delaware Description The ... Delaware Description The Associate Director, Compliance Nursing reviews utilization management activities and ... and abuse. The..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Dover Delaware Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
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 ..
... care, services, and supports in compliance with Ohio Department of Medicaid ... policies and procedures to ensure compliance with state and federal requirements ... management. For Behavioral Health, C.M...
Description The Director, Health Services Nursing serves as the strategic leader ... Director, Utilization Management Behavioral Health Nursing utilizes clinical nursing skills to support the coordination, ... Director, Utilization Management..
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..
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 ..
... Nationwide Associate Director, Utilization Management Nursing in Dover Delaware Description The ... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..