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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..
Description The Care Manager, Telephonic Nurse, in a telephonic environment, assesses ... needs and requirements to achieve and/or maintain optimal wellness state by ... members. The Care Manager, Telephonic Nurse..
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 Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
... plans, directs, coordinates, evaluates, develops, and/or delivers training and education programs ... where the analysis of situations or data requires an in-depth evaluation ... to, Care Management, Utilization Management,..
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..
... 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,..
... 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..
... analyzes data daily, weekly, monthly or as needed to assess outcome ... and could lead multiple managers or highly specialized professional associates. The ... Qualifications *Bachelor's Degree in health..
... needs and requirements to achieve and/or maintain optimal wellness state by ... allow each member to achieve and/or maintain their optimal health. Apply ... on identified needs and recommend..
Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2 work assignments are ... the SIU Non Lab team. Nurse Auditor 2 performs..
