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... Information Humana Medicaid Associate Director, Compliance Nursing in Albany New York ... York Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..
Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..
Description Job Description Summary The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations ..
... New York State and their compliance with the Home and Community ... Duties: Evaluate the case for compliance to applicable regulations. Clearly communicate ... data and documentation to support..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... New York Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
Description The Manager, Compliance Nursing reviews utilization management activities ... fraud, waste, and abuse. The Manager, Compliance Nursing works within specific guidelines ... schedules and goals. Responsibilities The Manager, Compliance..
... New York State and their compliance with the Home and Community ... Duties Evaluate the case for compliance to applicable regulations. Clearly communicate ... data and documentation to support..
The Center for Disability Services offers hope, innovation and achievement to the people we support.For 80 years, we have been one of upstate New Yorku2019s largest providers of programs and services ..
... are searching for a u00A0Practice Manager Primary Careu00A0to join our team. ... communities. Job Summary: The Practice Manager, Primary Care, contributes to the ... coordination of Primary Care ensuring..
The Center for Disability Services offers hope, innovation and achievement to the people we support.For 80 years, we have been one of upstate New York’s largest providers of programs and services ..
Description The Bilingual Manager, Learning Facilitation , plans, coordinates, ... Grievances and Appeals Learning Facilitation Manager Oversee a team of instructors ... Update as process change for compliance and oversight..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Albany New York Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that ..
... are searching for a RNu00A0Practice Manager in Primary Careu00A0to join our ... specialty services. The RN Practice Manager, Primary Care contributes to the ... coordination of Primary Care ensuring..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Albany New York Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
