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Description The Senior Policy Governance Professional policy Governance is the combination of Compliance processes established and executed that are reflected in the organization's structure and how it is managed and led ..
Description The Utilization Management Nurse utilizes clinical nursing ... and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... 8am-5pm EST The Front End Review nurse uses clinical..
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 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 ..
... refers to internal stakeholders for review depending on case findings. Educates ... case findings. Educates providers on utilization and medical management processes. Enters ... established guidelines/procedures. Required Qualifications Active..
Description The Utilization Management Nurse 2 utilizes clinical ... and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... the appropriate courses of action.The Utilization Management Nurse 2..
Description The Manager, Utilization Management Nursing utilizes clinical nursing ... benefit administration determinations. The Manager, Utilization Management Nursing works within specific ... and goals. Responsibilities The Manager, Utilization Management Nursing..
Description The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at ..
... related to medication cost and utilization Essential Functions: Include, but not ... focus on key financial and utilization metrics, clinical data, clinical medication ... formulary development and perform continuous..
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 ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing ... benefit administration determinations. The Manager, Utilization Management Nursing works within specific ... succeed, we succeed! The Manager, Utilization Management Nursing..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
Description The Utilization Management Nurse 2 utilizes clinical ... and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... as technology allows Responsibilities The Utilization Management Nurse 2..
Description The Utilization Management Behavioral Health Professional 2 ... and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 ... courses of action. Responsibilities The Utilization Management Behavioral Health..
... Associate Director, Compliance Nursing reviews utilization management activities and documentation to ... Medicaid markets and centralized clinical Utilization Management team, to assure efficient ... support staffing model revisions; Implement..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing ... administration determinations. The Associate Director, Utilization Management Nursing requires a solid ... delivery process. The Associate Director, Utilization Management..
Description The Utilization Management Nurse 2 utilizes clinical ... and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... Saturday, Sunday, Monday, Tuesday The Utilization Management Nurse 2..
... Required Qualifications Degree in Nursing RN license Compact state RN license Minimum of three (3) ... clinical experience Behavioral Health experience Utilization management experience Must have accessibility ... Desired..
