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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..
Pennsylvania, United States of America Job Family Group: Health Safety Environment and Security Worker Type: Regular Posting Start Date: January 29, 2021 Business unit: HR Corporate Functions Experience Level: Early Careers ..
Description The Utilization Management Nurse utilizes clinical nursing ... and/or benefit administration determinations. The Utilization Management Nurse work assignments are ... the Soul. Join Us! The Utilization Management Nurse 2..
... reviews, provider education on the utilization and medical management processes, entering/maintaining ... Required Qualifications 2 years of Utilization Management (UM), Pre-Auth, or other ... Pre-Auth, or other managed care..
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..
... refers to internal stakeholders for review depending on case findings Educates ... case findings Educates providers on utilization and medical management processes. Enters ... active compact or single state..
Description The Utilization Management Nurse 2 utilizes clinical ... Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments ... courses of action. Responsibilities The Utilization Management Nurse 2..
Description The Utilization Management Nurse utilizes clinical nursing ... and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... the Soul. Join Us! The Utilization Management Nurse 2..
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 The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
... refers to internal stakeholders for review depending on case findings. Educates ... case findings. Educates providers on utilization and medical management processes. Enters ... Qualifications Active Registered Nurse License..
... 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..
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..
Description CarePlus is seeking a Nursing Educator 2 who will plan, direct, coordinate, evaluate, develop, and/or deliver training and education programs for professional nursing personnel. The Nursing Educator 2 work assignments ..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes ... discussed during the interview. The Utilization Management Behavioral Health Nurse completes ... obtain sufficient clinical information...
Description The Utilization Management Nurse 1 utilizes clinical ... and/or benefit administration determinations. The Utilization Management Nurse 1 work assignments ... of moderate complexity. Responsibilities The Utilization Management Nurse 1..
Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
Description Responsibilities The Telephonic Nurse Case Manager will be a member of the Case Management Team, providing a comprehensive, holistic approach for case management throughout the continuum of care. The case ..
Description The Utilization Management Behavioral Health Nurse 2 ... and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 ... courses of action. Responsibilities The Utilization Management Behavioral Health..
PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality ..
