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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..
... Business unit: HR Corporate Functions Experience Level: Early Careers Job Description: ... periodic fitness to work & medical surveillance assessments, occupational injury/illness care, ... assessments, occupational injury/illness care, disability..
... effective utilization management strategies including: review of appropriateness of health care ... alternatives. ESSENTIAL RESPONSIBILITIES Implementu00a0care management review processes that are consistent with ... as other approved guidelines and..
Description Responsibilities The Telephonic Nurse Case Manager will be a ... implement, monitor, and evaluate the medical services required to meet the ... and to enhance quality of medical care...
Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, ... members. The Care Manager, Telephonic Nurse 2 work assignments are varied ... right questions and interpret complex medical..
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..
... have an immediate opportunity for Nurse Supervisors. 7p-7:30a, 3 days per ... Nursing to adjust staff, as necessary, by transferring individual staff members ... to another, arranging and approving..
... 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..
... Information Humana Utilization Management Registered Nurse, RN 2 in Pittsburgh Pennsylvania ... Pennsylvania Description The Utilization Management Nurse applies a Person-Centered approach, works ... problems. Responsibilities The Utilization Management..
... 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..
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..
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..
... The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... The Utilization Management Behavioral Health Nurse 2 work assignments are varied ... The Utilization Management Behavioral Health..
Description The Utilization Management Nurse 1 utilizes clinical nursing skills ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... administration determinations. The Utilization Management Nurse 1..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere ... in Pittsburgh Pennsylvania Description The Nurse Auditor 2 performs clinical audit/validation ... audit/validation processes to ensure that medical record documentation..
... 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..
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..
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..
Description The Nurse Auditor 2 will work on ... clinical lab audit concepts. The Nurse Auditor 2 will perform clinical ... and validation processes to ensure medical record documentation and..
