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Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
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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 Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
Description CarePlus is seeking a Clinical Business Lead who will lead teams of nurses and behavior health professionals responsible for Care Management and Utilization Management. The Clinical Business Lead works on ..
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..