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... maintain competitive cost structures. Each manager is responsible for a defined ... community service. The Patient Services Manager serves as the direct link ... Responsibilities 1. The Patient Services..
... day. The Assistant Patient Services Manager (APSM) is responsible for ensuring ... on a 24/7 basis. The Nursing strategic framework will be utilized ... flow is maintained and appropriate..
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..
Description The Director, Health Services Nursing serves as the strategic leader ... Director, Utilization Management Behavioral Health Nursing utilizes clinical nursing skills to support the coordination, ... Director, Utilization Management..
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 Senior Stars Improvement, Clinical Professional (RN/LPN) - Remote NY, NJ, CT, MA, ME, NH in Bridgeport Connecticut Description The Senior Stars Improvement, Clinical Professional (RN/LPN) role focuses on ..
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 ..
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 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 ..
... 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 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..
... of service. The Director of Nursing combines nursing and administrative skills to meet ... the challenge of leading the nursing operations in a nursing center. You will coordinate the..
... Recommend disciplinary action to Clinical Manager and initiate as appropriate. Ensure ... the absence on the Clinical Manager ensuring compliance with applicable regulations, ... and effective matter. With Clinical..
Job Information Humana Senior Stars Improvement, Clinical Professional (RN/LPN) - Remote NY, NJ, CT in Bridgeport Connecticut Description The Senior Stars Improvement, Clinical Professional (RN/LPN) role focuses on clinical and performance ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Bridgeport Connecticut Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation 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 .....
... for managing the day-to-day branch operations to ensure the following: operational ... plans, implements, analyzes and organizes operations for the Branch. Responsible for ... and support to the Clinical..
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..
... Nationwide Associate Director, Utilization Management Nursing in Bridgeport Connecticut Description The ... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate..
... care while maintaining cost-effective clinical operations in accordance with all legal, ... of an accredited School of Nursing (RN). Current appropriate state licensure. ... 12 months experience in clinical..
Job Information Humana Telephonic Care Manager in Bridgeport Connecticut Description The ... Connecticut Description The Telephonic Care Manager will be part of the ... coping skills. Responsibilities The Case Manager..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Connecticut Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
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 ..