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Job Information Humana Medicaid Associate Director, Compliance Nursing in Salem Oregon Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
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 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 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 Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere ... in Salem Oregon Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2..
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 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-Operating Room -TravelJob Description Working in the operating room with surgeons to keep the operating room sterile Execute proper use, care and handling of surgical equipment to ensure safety of ..
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 ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Salem Oregon Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
Specialty: RN - Med/Surg - TravelJob Description Integrates nursing interventions into the multidisciplinary plan of care, incorporating appropriate standards of care and practice and patient outcomes. Prepares and administers (orally, subcutaneously, ..
... 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..
Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Salem Oregon Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, ..
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 HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Salem Oregon Description The Risk Management Professional 2 identifies and analyzes potential sources of ..
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 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 ..
Specialty: Travel RN-CardiologyJob Description As cardiology clinical nurse work in hospitals, care for critically ill patients, as well as those recovering from cardiac procedures such as bypass, angioplasty, or pacemaker surgery. ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Salem Oregon Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
