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Description MUST BE BILINGUAL: CHINESE/ENGLISH (written and spoken proficiency)MUST HAVE WA RN LICENSE The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements ..
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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 Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
Description Be a part of the CenterWell leadership team, a subsidiary whose purpose is to provide care management program support resources to physicians, physician groups, and integrated healthcare delivery systems throughout ..
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 ..
... license from list: Registered Nurse (RN) with Compact License and general ... York License 3 years of practice experience 1 or more year ... post-degree clinical experience in private..
Psychiatrist/APRN, on site or from your current location: Busy, out-patient practice is looking for full-time and/or part-time psychiatrists/psychiatric nurse practitioners to join our team. Responsibilities include providing evaluations and medication management. ..
Job ID 21000AEOAvailable Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions ..
Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Description The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments ..
Description Humana's National Medicaid Quality team is seeking a Market Consultant to be responsible for supporting individual Medicaid market quality teams and serving as the main relationship broker and liaison to ..
... license from list: Registered Nurse (RN) with Compact License 3 years ... Compact License 3 years of practice experience 1 or more year ... post-degree clinical experience in private..
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 ..
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 As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
