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Description The Manager, Pre-Authorization Nursing reviews prior authorization ... guidelines and policies, and approves services or forward requests to the ... to the appropriate stakeholder. The Manager, Pre-Authorization Nursing works..
Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services, discharges and/or benefit administration determinations. The Utilization Management Nurse 2 work ..
... South Florida Regional VP, Health Services in Miramar Florida Description The ... Description The Regional VP, Health Services relies on medical background and ... claims. The Regional VP, Health..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... to 7:00pm. Responsibilities The Care Manager, Telephonic Nurse..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... of action. Responsibilities The Care Manager, Telephonic Nurse..
Job ID 21000M35Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
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..
... documentation and communication of medical services and/or benefit administration determinations. The ... most appropriate treatment, care or services for members. Coordinates and communicates ... most appropriate treatment, care or..