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... and communication of medical services and/or benefit administration determinations. The Manager, ... and most appropriate treatment, care or services for members. Coordinates and ... and communicates with providers, members,..
Description The WEEKEND Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization ..
Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2 work assignments are ... Humana is looking for a Nurse Auditor 2 Professional..
... and communication of medical services and/or benefit administration determinations. The Utilization ... Health Professional 2 - Registered Nurse completes telephonic and/or faxed reviews with the Utilization ... State Licensed..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
... coordinate interventions with the beneficiary's physician. Performs all duties within the ... in care, eligibility for assistance and/or need for care management program ... need for care management program..
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... the team with a Senior Nurse Auditor roles! This is a ... you answered YES to one or more of the above you ... should strongly consider the Senior..
... group practice with centers open or opening in Florida, Georgia, Kansas, ... environment for all. Responsibilities The Nurse Practitioner (NP) works in our team-based ... professionals, Pharm D, Care..
Description Job Summary The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. 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. The ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic ... needs and requirements to achieve and/or maintain optimal wellness state by ... members. The Care Manager, Telephonic Nurse..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills ... and communication of medical services and/or benefit administration determinations. The Utilization ... administration determinations. The Utilization Management Nurse 2..
... for Disease Management and Personal Nurse programs throughout the continuum of ... Facility (MTF) UM/CM/DM staff, physicians or providers to ensure there is ... in coordination with the beneficiaries'..
Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2 work assignments are ... courses of action. Responsibilities The Nurse Auditor 2 validates..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior ... and policies, and approves services or forward requests to the appropriate ... the appropriate stakeholder. The Pre-Authorization Nurse 2 work..
