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Description The Manager, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Manager, Pre-Authorization ..
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Description The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse ..
Description At Conviva Care Solutions, we want to inspire people to live life their best healthy life. Conviva Care Solutions is a management services organization representing nearly 300 physician practices, 800 ..
Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ... fraud, waste, and abuse. The RN Compliance Nurse 2 work assignments ... courses of action. Responsibilities..
Description The Utilization Management Nurse 2 utilizes clinical ... and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... courses of action. Responsibilities The Utilization Management Nurse 2..
Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., ..
Description The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate ..
