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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..
... every day. The Practice Operations Manager is responsible for managing various ... operating expense and budgets. The manager will work to meet best ... meet best practice operations. The..
Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, ..
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..
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..
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..
... the direction of the Pharmacy Manager or pharmacist, prepares, and files ... exercises independent judgment to ensure compliance and execution of all business ... equipment. In collaboration with Pharmacy..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Bridgeport Connecticut Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can ..
... Yale New Haven Health System Manager of Accreditation and Regulatory Affairs Department, Office of the ... coordinate, plan and organize overall regulatory compliance and readiness (e.g. CMS, DPH, .....
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 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 ..
... cost structures. The Patient Services Manager serves as the direct link ... Responsibilities 1. The Patient Services Manager is specifically responsible to: 2. ... 7. Understands, communicates all relevant..
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 ..
... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure ... in accordance with all legal, compliance, and regulatory requirements and programs. Adheres..
... as an Inpatient Oncology Nursing Manager? Now is your chance. The ... chance. The Inpatient Oncology Nursing Manager will be a full-time employee ... Jersey. The Inpatient Oncology Nursing..
... Information Humana Medicaid Associate Director, Compliance Nursing in Bridgeport Connecticut Description ... Connecticut Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Bridgeport Connecticut Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..