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Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ..
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Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation, and billing for services rendered, is complete, compliant and accurate to support optimal reimbursement. The Nurse ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
... inpatient care Licensed Registered Nurse (RN) in the (appropriate state) with ... obtain other state licensures based on business needs 3-5 years of ... Previous Medicare/Medicaid Experience a plus..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... functions and services to support 24/7 clinical operations delivery, Preauthorization List ... Medicaid; Implementing and hiring a 24/7 clinical support team for ability ... access to Care Management support..
... identifying, coordinating, and following through on quality concerns, sentinel events, complaints, ... license from list: Registered Nurse (RN) with Compact License and general ... contributing to an organization focused..
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 ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... health services Determine the needs on the faxes, making appropriate and ... identifying, coordinating, and following through on quality concerns, sentinel events, complaints, ... Required Qualifications Degree in Nursing..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
... Life Insurance 401(k) PTO including 7 paid holidays, one personal holiday, ... one day of volunteer time off, 23 days of annual PTO, ... Bachelor's degree Licensed Registered Nurse..
... Health, DME Licensed Registered Nurse (RN) in the (appropriate state) with ... obtain other state licensures based on business needs 3-5 years of ... Previous Medicare/Medicaid Experience a plus..
Description The Care Manager, Telephonic Behavioral Health 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 ..
