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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 .....
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..
... Managers. General Summary: The Case Manager coordinates and manages services provided ... staff, overseeing day to day operations of all care provided to ... successful patient outcomes. The Case..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Pennsylvania Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
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 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 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..
... Nationwide Associate Director, Utilization Management Nursing in Pittsburgh Pennsylvania Description The ... 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..
... 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 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 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 ..
... 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 Telephonic Care Manager in Pittsburgh Pennsylvania Description The ... Pennsylvania 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 Pittsburgh Pennsylvania Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
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..
... initiatives to drive practice growth.Clinic Operations Support* Ordering and maintaining adequate ... by Nurse Practitioner, Senior Practice Manager, Senior Clinician or Area Director.Required ... school of Practical or Vocational..
