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... 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..
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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 ... schedules and goals. Responsibilities The..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills ... administration determinations. The Associate Director, Utilization Management Nursing requires a solid understanding ... delivery process. The Associate Director,..
Job Information Humana Compact License-Utilization Management Behavioral Health Professional 2--Remote, MI, NV, CA, OH in ... Las Vegas Nevada Description The Utilization Management Behavioral Health Professional 2 utilizes ... and/or..
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..
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..
... under the direction of the Manager of Dental Operations. The individual ... and sentinel/serious reportable events and utilization issues by conducting retrospective chart ... cases to peer review quality..
Job Information Humana Manager, Utilization Management RN - Remote in Las Vegas Nevada Description ... Las Vegas Nevada Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... and/or..
Job Information Humana Telephonic Care Manager in Las Vegas Nevada Description ... Nevada Description The Telephonic Care Manager will be part of the ... of the Humana Military Case 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 Las Vegas Nevada Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care ..
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 ..
... 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)..
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..
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 ..
... Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Las Vegas Nevada ... Vegas Nevada Description The Risk Management Professional 2 identifies and..
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 .....
... 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..
