Nursing Operations Manager Jobs

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 Honolulu Hawaii Description The ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..

... 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..

Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..

Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... to resources, approach, and tactical operations for projects and..

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 .....

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 ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Hawaii Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..

Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Honolulu Hawaii Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, ..

Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Honolulu Hawaii Description The Risk Management Professional 2 identifies and analyzes potential sources of ..

Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Honolulu Hawaii Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..

... related problems to the Clinical Manager/Home Therapy Program Manager, and physician including the correct ... Submits CQI information to Clinical Manager or Program Manager for completion of HT QAI..

... physician. Initiates Initial and Annual Nursing Assessment and ongoing evaluation and ... Routinely meets with the Clinical Manager to discuss personnel and patient ... due. AnnuallyCompletes initial and annual..