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Description The Utilization Management Nurse utilizes clinical nursing skills to ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... administration determinations. The Utilization Management Nurse 2..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... patients throughout their care continuum. Experience working within a Value Base ... and a monthly guarantee *..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... administration determinations. The Utilization Management Nurse 2..
... channel) to providing support. Reviews medical records or claims to identify ... Qualifications An active unrestricted Registered Nurse (RN) license in the state ... Florida. 3 years of clinical..
... Humana Care Manager, Telephonic Registered Nurse, (RN) 2 in Dover Delaware ... Description The Care Manager, Telephonic Nurse 2 , in a telephonic ... members. The Care Manager, Telephonic..
... The Supervisor, Pre-Authorization Nursing: Completes medical necessity and level of care ... refers to internal stakeholders for review depending on case findings. Educates ... Educates providers on utilization and..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls ... The NAL Care Manager, Telephonic Nurse Assistant 2 is knowledgeable about ... and work independently. Responsibilities The Nurse..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... seeking a dedicated, compassionate, and experience - Utilization Management RN Manager ... OR Provide documentation for a..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere ... in Dover Delaware Description The Nurse Auditor 2 performs clinical audit/validation ... audit/validation processes to ensure that medical record documentation..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills ... coordination, documentation and communication of medical services and/or benefit administration determinations ... Medicaid Plan. The Utilization Management Nurse 2..
... team of 20-25 nurses and medical professionals that performs the following ... that performs the following functions: medical necessity/level of care reviews, provider ... education on the utilization and..
... The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and ... coordination, documentation, and communication of medical services. Enjoy the flexibility of ... three (3) years of clinical..
... ManagementLocation:Shift:Job Details: Responsible for coordinating medical care, and matching patient needs ... patient care.Requirements: Previous Case Management experience in an Inpatient/Acute Care Hospital ... Care Hospital Setting - Required..
Job Information Humana Nurse Advice Line Telephonic Nurse - Remote- RN Compact License ... Description The Care Manager, Telephonic Nurse 2 , in a telephonic ... members. The Care Manager,..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... Management authorizations. Working with Market Medical Directors and vendors to develop ... processes for routing cases for..
... Information Humana Utilization Management Registered Nurse - Remote in Dover Delaware ... Delaware Description The Utilization Management Nurse utilizes clinical nursing skills to ... coordination, documentation and communication of..
Description The Nurse Auditor 2 performs clinical audit/validation ... audit/validation processes to ensure that medical record documentation and diagnosis coding ... support optimal reimbursement. Responsibilities The Nurse Auditor 2 validates..
Job Information Humana Nurse Advice Line Telephonic Nurse - RN Compact License States ... Description The Care Manager, Telephonic Nurse 2 , in a telephonic ... members. The Care Manager,..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for ... without direction. Responsibilities Senior Pre-Authorization Nurse: Serves as a team lead ... outcomes, and process efficiencies. Completes medical necessity..
Job Information Humana Senior Medical/Financial Risk Clinical Professional in Dover ... Dover Delaware Description The Senior Medical/Financial Risk Clinical Professional is responsible ... development, implementation and monitoring of medical/financial risk...
... both mental illness and complex medical situations. Our goal is to ... right questions and interpret complex medical/behavioral health content in an effort ... effort to enhance the member..
... Information Humana Utilization Management Registered Nurse, RN 2 in Dover Delaware ... Delaware Description The Utilization Management Nurse applies a Person-Centered approach, works ... problems. Responsibilities The Utilization Management..
