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Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... you succeed, we succeed! The Manager, Care Management oversees..
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..
... Information Humana Medicaid Associate Director, Compliance Nursing in Colorado Springs Colorado ... Colorado Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 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 relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
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 AVP, Stars and Risk Adjustment National Medical Director in Colorado Springs Colorado Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that ..
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 ..
... looking for a skilled Nurse Manager Labor and Delivery to join ... rocky mountain communities. The Nurse Manager Labor and Delivery will be ... rocky mountain region. The Nurse..
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 ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Springs Colorado Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Colorado Springs Colorado Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to ..
... exciting opportunity for a Nurse Manager Medical Surgical Renal position is ... unparalleled patient satisfaction. The Nurse Manager Surgical Renal will be an ... care and safety. The Nurse..
