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Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
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 ..
Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization ... to the appropriate stakeholder. The Supervisor, Pre-Authorization Nursing works within thorough, ... and analytical approach. Responsibilities The Supervisor, Pre-Authorization Nursing: Completes..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls ... The NAL Care Manager, Telephonic Nurse Assistant 2 is knowledgeable about ... and work independently. Responsibilities The Nurse..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Brentwood Tennessee Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Description The Learning Facilitation Professional 2 (LFP2) plans, coordinates, conducts or facilitates learning experiences for Humana Military associates and/or external audiences. The LFP2 creates an environment that is conducive to learning ..
... under the direction of a RN in compliance with the state's ... in compliance with the state's Nurse Practice Act, any applicable licensure/certification ... and outcomes. Confer with the..
Description The Integrated Model for D-SNP team is focused on delivering an integrated member experience through a multidisciplinary team. Focused on the highest risk D-SNP members, this team coordinates both inbound ..
... direct supervision of a licensed nurse in accordance with FMCNA policies, ... complaints or observations to the nurse supervisor. Evaluate vascular access for patency ... report any unusual findings..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Job Information Humana Referrals Coordinator 2 in Brentwood Tennessee Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
