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... Humana Medicaid Associate Director, Compliance Nursing in Jersey City New Jersey ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate Director, Utilization Management Nursing requires a solid understanding of ... grow, the..
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 .....
... 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..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Jersey City New Jersey Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record ..
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 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 ..
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..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Jersey Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
Job Information Humana Senior Stars Improvement, Clinical Professional (RN/LPN) - Remote NY, NJ, CT, MA, ME, NH in Jersey City New Jersey Description The Senior Stars Improvement, Clinical Professional (RN/LPN) role ..
Job Information Humana Senior Stars Improvement, Clinical Professional (RN/LPN) - Remote NY, NJ, CT in Jersey City New Jersey Description The Senior Stars Improvement, Clinical Professional (RN/LPN) role focuses on clinical ..
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..
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 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..
... Nationwide Associate Director, Utilization Management Nursing in Jersey City New Jersey ... The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... The Associate..
Job Information Humana Telephonic Care Manager in Jersey City New Jersey ... Jersey 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 ..
Job Information Humana Senior Market Development Professional-RN-WAH Nationwide in Jersey City New Jersey Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE ..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Jersey City New Jersey Description The Risk Management Professional 2 identifies and analyzes potential ..
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... schedules and goals. Responsibilities The Manager, Care Management oversees..
