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... to make determinations whether requested services, requested level of care, and/or ... and appeals processes, and outpatient services and equipment, within their scope. ... medical interpretation and determinations whether..
Description Your Home Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving clinical and quality outcomes by bridging the gap between the physician's office and the member's home. YHA ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Manager, Utilization Management Nursing utilizes clinical ... documentation and communication of medical services and/or benefit administration determinations. The ... and/or benefit administration determinations. The Manager, Utilization Management Nursing..
... Birmingham Alabama Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... with oversight from the NAL..
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 ..