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Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Director, Health Services utilizes clinical nursing skills to support the coordination, ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... function or segment. Responsibilities..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Lancaster South Carolina Description ... South Carolina Description The Associate Director, Compliance Nursing reviews utilization management activities and ... waste, and..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
Description The Transplant Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates transplant members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families ..
Description 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 Utilization Management ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Lancaster South Carolina Description ... South Carolina Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
... operations. You will develop the nursing and clinical department goals, objectives, ... and implementing the Standards of Nursing Practice and the clinical operations ... of experience at a senior..
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 ..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
Description The Chief Medical Officer, Group Medicare relies on the medical background to create and oversee clinical strategy for the Group Medicare business. The CMO Group Medicare, requires and in-depth understanding ..
Description Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions. Consumers expect more personalized and holistic experiences from their health partners. Humana's Enterprise Clinical Operating ..
Job Information Humana RN Telephonic Transplant Care Manager-WAH in Lancaster South Carolina Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements ..
Job Information Humana Associate Vice President, Quality Improvement for Healthy Horizons in Lancaster South Carolina Description As a company whose primary focus is on the well-being of its members, Humana is ..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... benefit administration determinations. The Associate Director, Utilization Management Nursing requires a solid understanding of..
Description The Director, Health Services utilizes clinical nursing skills to support the coordination, ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... segment. Responsibilities The SC..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the flexibility ..
Job Information Humana Director, Behavioral Health Strategy in Lancaster South Carolina Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care ..
