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Description The Senior Stars Improvement, Clinical Professional is responsible for the ... program. The Senior Stars Improvement, Clinical Professional work assignments involve moderately ... Responsibilities The Senior Stars Improvement, Clinical..
Description The Senior Quality Assurance, Clinical Professional requires being both a ... critical review judgment to make clinical determinations Knowledge of inpatient and ... of 3-5 years of general nursing..
... Humana Medicaid Associate Director, Compliance Nursing in Green Bay Wisconsin Description ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, ... plan. The Senior Provider Engagement, Clinical Professional work assignments involve moderately ... Responsibilities The Senior Provider Engagement, Clinical..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product ... Product Strategy team. The Senior Clinical Business Professional work assignments involve ... at home anywhere..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
... will be responsible for performing clinical audits on medical record documentation ... record documentation for quality and clinical compliance with contract requirements as ... of three (3) years of..
... Summary:u0026nbsp; u0026nbsp;u003c/strongu003eu003c/pu003enu003cpu003eThe Prior Authorization Nurse Analyst is a work from home ... and want to use your nursing knowledge in a new and ... decision making based on your..
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u003c/strongu003eu003c/pu003enu003cpu003eThe Clinical Supervisor (RN) will oversee a team of 20 to 30 remote Medical Review Nurseu0026nbsp; Analysts (NA) that complete Targeted Probe and Educate (TPE) work for our Medicare ..
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 ..
Description Humana's recently created Clinical Resource Team is looking to ... Do you have a solid clinical background in acute care? Well, ... Auditor opportunity with Humana. Performs clinical audit/validation..
