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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 ..
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 ..
... 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 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 ..
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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 ..
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 ..
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 ..
... providers. Required Qualifications Current US RN License with Coding experience 3 ... to support the CDC recommendations on social distancing and reduce health ... Talent Acquisition representative will advise..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
... 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..
... 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..
... Care has a strong emphasis on senior-focused primary care for members ... careers. Our culture is focused on teamwork and providing a positive ... value based care provider focused..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
... identifying, coordinating, and following through on quality concerns, sentinel events, complaints, ... license from list: Registered Nurse (RN) with Compact License 3 years ... contributing to an organization focused..
... equired Qualifications Licensed Registered Nurse (RN) in the (appropriate state) with ... contributing to an organization focused on continuously improving consumer experiences Must ... with CMS guidelines a plus..
... 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..
