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... Humana Medicaid Associate Director, Compliance Nursing in Lancaster South Carolina Description ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
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 .....
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Carolina Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
Description Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will assess, plan, coordinate, implement, ... Care Management Team, the care manager..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Lancaster South Carolina Description The Risk Management Professional 2 identifies and analyzes potential sources ..
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 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 Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Lancaster South Carolina Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ..
... South Carolina Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... that provides Humana members with..
... Nationwide Associate Director, Utilization Management Nursing in Lancaster South Carolina Description ... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate..
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 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 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 ..
... patient care outcomes and facility operations. PRINCIPAL DUTIES AND RESPONSIBILITIES: All ... Care policy, procedures, standards of nursing practice, state and federal regulations. ... the direction of the Clinical..
Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Lancaster South Carolina Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product ..
Job Information Humana Telephonic Care Manager in Lancaster South Carolina Description ... Carolina Description The Telephonic Care Manager will be part of the ... coping skills. Responsibilities The Case Manager..
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 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 ..
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 ..
... 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..
