Nurse Analyst Jobs in Billings

Description The Senior Stars Improvement, Clinical Professional (RN or LPN) responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Senior Stars Improvement, Clinical Professional work ..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Billings Montana Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..

Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..

Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of ..

Job Information Humana Senior Clinical Recruiter in Billings Montana Description The Senior Clinical Recruiter recruits qualified applicants for staff nurse or other positions requiring registered nurse licensure, licensed practical nurse, or ..

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..

Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..

Description The Senior Nursing Educator plans, directs, coordinates, evaluates, develops, and/or delivers training and education programs for professional nursing personnel. The Senior Nursing Educator work assignments involve moderately complex to complex ..

Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..

Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Billings Montana Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..

Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..

Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere ... in Billings Montana Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2..

Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Billings Montana Description The Risk Management Professional 2 identifies and analyzes potential sources of ..

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 ..

Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Billings Montana Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Billings Montana Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..

Description The Senior Stars Improvement, Clinical Professional (RN or LPN) responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Senior Stars Improvement, Clinical Professional work ..

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..

Description RN - Provider Clinical Liaison contributes to administration of utilization management. The RN - Provider Clinical Liaison work assignments involve moderately complex to complex issues where the analysis of situations ..

Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The Nurse ..