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... 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'..
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... 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 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..
... where the analysis of situations or data requires an in-depth clinical ... responsibilities include: Attend meetings with physician groups to address areas of ... areas of clinical utilization. Educate..
... 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 -..
... 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 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..
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 Manager, ... and most appropriate treatment, care or services for members. Coordinates and ... and communicates with providers, members,..
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 ..
... 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..
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..
... 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 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, ..
... 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 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 work..
