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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines ... you succeed, we succeed! The..
... not be limited to, Care Management, Utilization Management, and/or Compliance. RN licensure is required at all ... Valid Unrestricted Registered Nurse License (RN) in home state and compact .....
... Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... and quality performance and staffing management. Detailed Responsibilities include: Leads Medicaid ... Medicaid operational process and..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description The Utilization Management Nurse 2 utilizes clinical nursing ... and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... courses of action. Responsibilities The Utilization Management..
... not be limited to, Care Management, Utilization Management, and/or Compliance. Understands department, segment, ... established guidelines/procedures. Required Qualifications Unrestricted RN License. Three (3) years of ... License. Three (3)..
... Advice Line Telephonic Nurse - Remote- RN Compact License States Only in ... New Mexico Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The..
Description The Remote Systems Clinical Pharmacist will provide ... relationships with Account / Clinical Management and PCO-IPU Operations teams. Responsibilities ... PCO-IPU Operations teams. Responsibilities Location: Remote USA, preferred East..
... Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the ... solve basic problems; collaborates with management and top professionals/specialists in selection ... reviews, provider education on the..
... Advice Line Telephonic Nurse - RN Compact License States Only in ... New Mexico Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care..
Description The Utilization Management Behavioral Health Nurse 2 utilizes ... and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work ... courses of action. Responsibilities The Utilization Management..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
... of experience in Accreditation, Quality Management, Compliance, Utilization Management, Behavioral Health, and/or Case Management Exceptional analytical and critical thinking ... to detail Demonstrated excellent time management skills with proven..
Description The Utilization Management Behavioral Health Professional 2 utilizes ... and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... courses of action. Responsibilities The Utilization Management..
... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... is responsible for client cost management and satisfaction. The Clinical Liaison ... related to medication cost and..
Job Information Humana Director, Behavioral Health Strategy in Albuquerque New Mexico Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care ..
Job Information Humana RN-Care Manager, Behavioral Health-RN in an eNLC state required ... New Mexico Description The Care Manager, Telephonic Behavioral Health 2, in ... wellbeing of members. The Care..
Job Information Humana Telephonic Care Manager in Albuquerque New Mexico Description ... Mexico Description The Telephonic Care Manager will be part of the ... of the Humana Military Case Management..
Job Information Humana Manager, Utilization Management RN - Remote in Albuquerque New Mexico Description ... Albuquerque New Mexico Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... and/or..
... Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Albuquerque New Mexico ... New Mexico Description The Risk Management Professional 2 identifies and..
