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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 ..
Job Information Humana Social Worker - Telephonic Behavioral Health ... a member's physical, environmental and psycho-social health issues. Identifies and resolves ... Required Qualifications Master's degree in Social Work. Current..
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 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 ..
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 ..
... specific care plan and coordinates services Ensures members are receiving services in the least restrictive setting ... to meet those needs Coordinating services, and monitoring and evaluating the .....
Description The Care Management Support Assistant 3 contributes to administration of ... members. The Care Management Support Assistant 3 performs advanced administrative/operational/customer support ... Responsibilities The Care Management Support Assistant..
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 ..
Job Information Humana Social Worker-MSW and licensure required- Telephonic ... a member's physical, environmental and psycho-social health issues. Identifies and resolves ... Required Qualifications Master's degree in Social Work. Current..
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 The WEEKEND Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization ..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
... a member's physical, environmental and psycho-social health issues. Consult with your ... experience. Coordinate community care and services as deemed appropriate. Understand clinical ... referrals Coordinate community care and..
