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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 ..
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 Washington District Of Columbia ... Columbia Description The Associate Director, Compliance Nursing reviews utilization management activities and ... and abuse. The..
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... Nationwide Associate Director, Utilization Management Nursing in Washington District Of Columbia ... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate..
... philosophy. Adheres to the FMS Compliance Program, including following all regulatory ... programs which require the case manager to meet the patient, the ... RN required with active unrestricted..
Director - Ambulatory Transformation (EVERGREEN)','2300016R','!*!The Director of Ambulatory Transformation (AT) reports directly to the Executive Director, Ambulatory Services, CNH and collaborates in the development of the strategic and operational roadmap of ..
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 Associate VP, Health Plan Quality Improvement and Performance in Washington District Of Columbia Description The Associate VP, strategically identifies, develops, and implements programs that influence providers, members or ..
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 ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Of Columbia 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 ..
... 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..
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..
Job Information Humana Associate VP, Quality Improvement in Washington District Of Columbia Description The AVP, Quality Improvement and Performance will develop, maintain, own and execute strategies to improve performance of 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 ..
