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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 ..
... needs and requirements to achieve and/or maintain optimal wellness state by ... the importance of preventive screenings or medication adherence and is trained ... for specific case management and..
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... you answered YES to one or more of the above you ... Required Qualifications Licensed Registered Nurse, RN, in the state of residence ... current coding certifications with AAPC..
... and communication of medical services and/or benefit administration determinations. The Utilization ... and most appropriate treatment, care or services for members. Coordinates and ... and communicates with providers, members,..
... and communication of medical services and/or benefit administration determinations. The Utilization ... - Registered Nurse completes telephonic and/or faxed reviews with the Utilization ... 7am - 6:30 p.m. CST..
... and communication of medical services and/or benefit administration determinations. The Manager, ... and most appropriate treatment, care or services for members. Coordinates and ... and communicates with providers, members,..
Description The RN, Mom's First Field Care Manager ... needs and requirements to achieve and/or maintain optimal wellness state by ... and wellbeing of members. The RN, Mom's First Field..
Job Information Humana RN, Field Care Manager Nurse 2 ... in Tulsa Oklahoma Description The RN, Field Care Manager Nurse 2 ... needs and requirements to achieve and/or maintain optimal..
... and communication of medical services and/or benefit administration determinations. The Utilization ... and most appropriate treatment, care or services for members. This is ... and communicates with providers, members,..
... The registered professional nurse (CAP RN 1) position is an entry ... for Registered Nurses. The CAP RN 1 is accountable and responsible ... health care team, the CAP..
... and policies, and approves services or forwards requests as needed. The ... license from list: Registered Nurse (RN) with Compact License 3 years ... years of practice experience 1..
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 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 ..
... as assigned by Supervisor, Manager and/or Director. 5% Utilizes established reporting ... description in no way states or implies that the key accountabilities ... required to follow other instructions..
... needs and requirements to achieve and/or maintain optimal wellness state by ... monitoring patient care through assessments and/or evaluations. May create member care ... multidisciplinary team. All of our..
... needs and requirements to achieve and/or maintain optimal wellness state by ... courses of action. Responsibilities The RN Care Manager, Telephonic Nurse 2 ... every 6 months; complete PSI..
... in care, eligibility for assistance and/or need for care management program ... need for care management program or other referral services in collaboration ... Social Determinants of Health needs..