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Constellis was established in 2010 by a group of operators and investors who sought to combine best-in-class brands, assets and people within the complex risk management industry. Today, the leading provider ..
Job ID 21000IW3Available Openings 1Position Specific Information $15,000 SIGN ON BONUS PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement ..
Job ID 21000LQ0Available Openings 3Position Specific Information $2,500 Sign-on bonus for non certified PCTs. $5,000 Sign-on bonus for CCHT certified PCTs.PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer ..
Description The Medicaid Housing Specialist (Care Management Support Professional 1)contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or ..
... of concern and recommendations for improvement, including corrective action requests in ... schedules. Train providers on auditing process and develop educational material related ... in driving provider level quality..
... every aspect of the claims process, including initial claim payment, claim ... the development and implementation of process improvement projects. Ensures that appropriate concurrent ... claims management experience in..
... is seeking a Manager, Quality Improvement who will implement and monitor ... will implement and monitor quality improvement program components, including annual program ... annual evaluation. The Manager, Quality..
... with benchmarks, identify opportunities for process improvement, and develop recommendations to leadership. ... Bachelor's degree in health services, healthcare administration, or related field. Experience ... managing staff who review..
... expert in value-based contracting, performance improvement, HEDIS and quality improvement. This individual represents Humana Healthy ... and participation in Humana's quality improvement and compliance initiatives. Monitors all ... for..
Description The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for ..
Description Humana Healthy Horizons in Louisiana is seeking a RN, Manager of Care Management to lead our Maternal-Child health care management operations and staff for the Moms First program, to ensure ..
PURPOSE AND SCOPE:Functionsas part of the Inpatient Services Hemodialysis Health Care team in providing safe and effective dialysis therapy for assigned patients inaccordance with FMCNA policies, procedures, and training and in ..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management (Behavioral Health) who will utilize clinical skills to support the coordination, documentation, and communication of behavioral health services and/or ..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Care Management (Behavior Health) who will lead our behavioral health care management operations and staff to ensure timely and culturally-competent delivery ..
... integration performance, network adequacy, performance improvement projects, and surveys related to ... work closely with the Performance/Quality Improvement Coordinator, Behavioral Health Network Director, ... of experience in managing behavioral..
Description Humana Healthy Horizons in Louisiana is seeking RN Managers of Care Management who will lead our physical health/behavioral health care management operations and staff to ensure timely and culturally-competent delivery ..
Description Humana Healthy Horizons in Louisiana is seeking a RN, Clinical Educator (Nursing Educator 2) who will plan, direct, coordinate, evaluate, develop, and/or deliver trainings and education programs for professional nursing, ..
POSITION FEATURES: PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP RN 1 is ..
... regarding the certification and licensure process at all times. Responsible for ... company policies. Conducts continuous quality improvement quarterly committee meetings, reviews all ... Minimum of 2 years of..
Job ID 21000MUEAvailable Openings 1PURPOSE AND SCOPE: Entry level position focuses on the development of Knowledge, Skills, and Abilities (KSA) in a supervised environment with the intent of developing performance and ..
