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Description Humana's recently created Clinical Resource Team is looking to grow the team with a couple Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly ..
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 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 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 Dover Delaware Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2..
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 Medicaid Associate Director, Compliance Nursing in Dover Delaware Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
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 ..
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 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 ..
POSITION FEATURES: *No Sundays, e/o Saturday, limited late shifts (outpatient only) *Tuition reimbursement *Clinical Advancement Program (CAP)- gain knowledge/increase pay *Growth opportunity including geographic movement and niche disciplines *Full benefits package ..
Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Dover Delaware 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 Dover Delaware Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
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 ..
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 ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Dover Delaware Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Dover Delaware Description The Risk Management Professional 2 identifies and analyzes potential sources of ..
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 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 ..
