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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and .....
... Humana Medicaid Associate Director, Compliance Nursing in Cincinnati Ohio Description The ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
Job Information Humana Manager, Care Management(Behavioral Health) - Ohio ... our behavioral health care management operations and staff to ensure timely ... quality patient care and effective operations. Collaborate with..
Description The Manager, Quality Improvement implements quality improvement ... Diagnosis and Testing (EPSDT). The Manager, Quality Improvement works within specific ... schedules and goals. Responsibilities The Manager, Quality Improvement is..
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 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 facilitate ..
Job Information Humana Manager, Care Management (Ohio Medicaid) - ... physical health/behavioral health care management operations and staff to ensure timely ... quality patient care and effective operations. Collaborate with..
... UC Investigators. The Clinical Research Manager oversees the implementation of clinical ... clinical trials, the Clinical Research Manager has duties that include but ... the CTO Associate Director of..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... Government. Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
... or behavioral health care management operations and staff to ensure timely ... quality patient care and effective operations. Collaborate with relevant internal and ... management. For Behavioral Health, C.M...
Job Information Humana Telephonic Care Manager in Cincinnati Ohio Description The ... Ohio Description The Telephonic Care Manager will be part of the ... coping skills. Responsibilities The Case Manager..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Cincinnati Ohio Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
... Nationwide Associate Director, Utilization Management Nursing in Cincinnati Ohio Description The ... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate..
Job Information Humana RN, Manager of Care Management (Maternal-Child Health) ... Ohio is seeking a RN, Manager of Care Management will lead ... our Maternal-Child health care management operations and..
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 The Manager, Compliance Nursing reviews utilization management activities and ... fraud, waste, and abuse. The Manager, Compliance Nursing works within specific guidelines and ... schedules and goals. Responsibilities The..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Ohio Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
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 Description WFH anywhere from US EST This is a full-time telework role. Schedule is Monday-Friday, standard business hours, with weekend coverage required, as needed. The Team Lead is accountable to ..
... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary. The PDC Care Manager will assist beneficiaries as they ... Military TRICARE - PDC Care..
