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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..
... Compliance Program, including following all regulatory and FMS policy requirements. Ensure ... with all legal, compliance, and regulatory requirements and programs. Adheres to ... standards through meeting all ESRD..
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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 ..
PURPOSE AND SCOPE:The student intern supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. The student ..
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 ..
POSITION FEATURES:Location: Grady HospitalMUST HAVE DIALYSIS EXPERIENCE - APHERESIS EXPERIENCE PURPOSE AND SCOPE:The Apheresis RN spends 80% or more of their time providing Apheresis treatments providing direct patient care in accordance ..
... exciting opportunity for a Compliance Manager! Assists the Director, Compliance Services ... all changes in accreditation and regulatory laws, policies, procedures and standards ... audits and the results of..
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 ..
Airport Concessions Manager Airport Concessions Manager - Compliance General Description and ... and ensuring concessionaires comply with regulatory standards of the City, FDA, ... efforts of contracted consultants in project..
PURPOSE AND SCOPE:Responsible for the day-to-day program operations and supporting the growth of the assigned single site Home Therapies program in coordination with the Business Unit management, in-center staff and other ..
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 ..
Job Information Humana Senior Project Manager -- Remote in Atlanta Georgia ... Atlanta Georgia Description The Senior Project Manager manages all aspects of a ... manages all aspects of a..
**Company :**Highmark Inc.**Job Description :****JOB SUMMARY**This job has primary ownership and oversight over a specified panel of oncology members that range in health status/severity and clinical needs. The incumbent assesses health ..
... 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..
