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Job Information Humana Medicaid Associate Director, Compliance Nursing in Cincinnati Ohio 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 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 ..
Specialty: RN-Oncology-TravelJob Description Leads the planning of care and implementation of the nursing process Plans unit scheduling, workflow, assignments, reviews work for accuracy Identifies staff development needs and coordinates education through ..
Description The Senior Quality Compliance Nurse Professional is an integral part of the Ohio Quality Improvement Department. This role will collaborate with internal and external customers to complete fast-paced and time ..
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 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 ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Cincinnati Ohio Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Job Information Humana Senior Nursing Educator - Remote OH, IN, KY in Cincinnati Ohio Description The Senior Nursing Educator plans, directs, coordinates, evaluates, develops, and/or delivers training and education programs for ..
Specialty: RN-Medical Surgical -TravelJob Description Registered nurses in this specialty practice primarily on hospital units and care for adult patients who are acutely ill with a wide variety of medical problems ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere ... in Cincinnati Ohio Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2..
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 ..
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 ..
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 ..
... weeks.PURPOSE AND SCOPE:The professional registered nurse Inpatient Services RN CAP 1 ... in collaboration with another Registered Nurse.Performs ongoing, systematic collection and analysis ... notifies Supervisor, Physician, patient’s primary..
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 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 ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Cincinnati Ohio Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
