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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 ..
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... 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..
... Information Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania Description The ... Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management activities and ... and abuse. The..
... Nationwide Associate Director, Utilization Management Nursing in Pittsburgh Pennsylvania Description The ... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate..
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 ..
Job Description The Delivery Driver Lead is responsible for the quality and efficiency of the delivery drivers and their operations. In this high impact role, you will serve as a liaison ..
... 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..
Job Description : JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate resource utilization, identification of opportunities ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Pittsburgh Pennsylvania Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
Sr Project Manager The Sr. Project Manager is primarily responsible to execute ... to complex problems. The Project Manager is responsible for the daily ... Conduct or assist senior project..
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 ..
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 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 ..
