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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 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 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..
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... 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..
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..
... 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 Utilization Management Nurse utilizes clinical nursing skills to ... and communication of medical services and/or benefit administration determinations. The Utilization ... administration determinations. The Utilization Management Nurse 2..
... 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..
... 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 ... 7am -..
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..
... and policies, and approves services or forwards requests as needed. The ... Health Professional 2 - Registered Nurse you will contribute to the ... unrestricted license from list: Registered..
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..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for ... as assigned by Supervisor, Manager and/or Director. 5% Utilizes established reporting ... description in no way states or..
... 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..
