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Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
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Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..
Description The Compliance Manager ensures compliance with governmental requirements. ... with governmental requirements. The Compliance Manager works on problems of diverse ... to substantial. Responsibilities The Compliance Manager develops and..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care ..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires ..
Description The Manager, Compliance (UM) conducts and summarizes ... schedules and goals. Responsibilities The Manager, Compliance (UM) collects and analyzes ... across the department. The Compliance manager will oversee clinical..
Description Humana is seeking an Associate Director, Quality Compliance Nursing that works with physicians/physician groups to ensure highest accountability of compliance and quality. The Associate Director, Quality Compliance Nursing requires a ..
... Number: 22000459 Description Assistant Nurse Manager Emergency Department AdventHealth Tampa Location ... daily and collaborate with Nurse Manager on completing monthly variance report ... In collaboration with the Nurse..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
... Information Humana Health Services Compliance Manager - Remote FL in Tampa ... in Tampa Florida Description The Manager, Compliance (UM) conducts and summarizes ... and summarizes compliance audits. The..
Job Information Humana Senior Project Manager -- Remote in Tampa Florida ... Tampa Florida Description The Senior Project Manager manages all aspects of a ... manages all aspects of a..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
... Specific Information ***This clinic will manager between 50-125 patients***PURPOSE AND SCOPE: ... Compliance Program, including following all regulatory and FMS policy requirements. Ensure ... with all legal, compliance, and..
... provider experience, as well as project manage the market rollout end-to-end. ... Medicaid markets Create and manage project plans to ensure effective and ... and timelines for provider services..
Description Humana is a Fortune 40 market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and well-being of the ..
Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
