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Description The Nurse Auditor 2 performs clinical audit/validation ... audit/validation processes to ensure that medical record documentation and diagnosis coding ... to support optimal reimbursement. The Nurse Auditor 2 work..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... maintain all activities and processes necessary to maintain compliance with NCQA ... providers throughout the region. Weekly..
... direct supervision of a licensed nurse in accordance with FMCNA policies, ... complaints or observations to the nurse supervisor. Evaluate vascular access for ... report any unusual findings to..
... of advance directive wishes, if necessary, with the healthcare team and ... collaboration with the physician and nurse, participates in the discussion of ... level. Participates in monthly Quality..
... is seekign a Utilization Management Nurse 2 who utilizes clinical nursing ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... administration determinations. The Utilization Management..
... Information Humana Care Manager, Registered Nurse, RN - Maternity, L&D, Mother ... Responsibilities The Field Care Manager Nurse 2 (Care Manager Plus, Physical ... person-centered care plan completion, ensuring..
... Behavioral Health Professional or Registered Nurse in Lima Ohio Description The ... person-centered care plan completion, ensuring no duplication with the CCEs (Ohio ... in field of study with..
... Quality Compliance Professional 2 completes medical records reviews for Coordination of ... corrective actions as needed. Reviews medical records for supplemental data and ... Required Qualifications Associate Degree Registered..
... services. Required Qualifications Licensed Registered Nurse (RN) or Licensed Behavioral Health ... the state of Ohio, with no disciplinary action. Must reside in ... Ohio. Minimum Five (5) years'..
... Horizons is seeking a Pre-Authorization Nurse 1 who will review prior authorization requests for appropriate ... the appropriate stakeholder. The Pre-Authorization Nurse 1 work assignments are often ... moderate..
