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... 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..
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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 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 ..
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 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 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 ..
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 ..
... 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..
... 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..
... 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 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 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, ..
... 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 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 Job Summary 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 ..
... 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..
