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Job Information Humana Medicaid Associate Director, Compliance Nursing in Newport Rhode Island Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
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 ..
... AND SCOPE: The registered professional nurse (CAP RN 1) position is ... and notifies Team Leader, Charge Nurse, Clinical Manager or Physician as ... a Team Leader or designated..
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 ..
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 ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Newport Rhode Island Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be ..
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 Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere ... Newport Rhode Island Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2..
Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Newport Rhode Island Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product ..
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 ..
Specialty: RN-ICU/CCU -TravelJob Description Assist physicians with patient management Provide patient care to the critically ill Collaborate with other disciplines to ensure effective and efficient patient careQualifications and Job Info 1-2 ..
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 Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Newport Rhode Island Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..
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 ..
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 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 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 ..
Specialty: RNRHLTJob Description Registered nurses (RNs) monitor patients, develop patient care plans, implement treatments and provide guidance. RNs who provide in-home care or who work in a care facility can supervise ..
... with an assigned Preceptor & Nurse Educator70,000+ dedicated employees, 200,000+ patients, ... AND SCOPE: The registered professional nurse (CAP RN 1) position is ... appropriately credentialed physician, patient's primary..
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 ..
