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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..
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..
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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..
... 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..
... 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 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..
... 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 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 ..
... 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 processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
... 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..
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..
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, ..
