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Description The RN Care Manager 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 facilitate interaction with ..
Description The 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 Behavioral ..
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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 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 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 CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
Description Humana is looking for an experienced Counselor that truly enjoys helping those in need within a call center environment. Our Counselor's provide ongoing and crisis intervention counseling focused on 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 .....
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 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 ..
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 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 ..
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 ..
... 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..
... management program or other referral services in collaboration with Humana Government ... approaches in communication delivery. Identify Social Determinants of Health needs and/or ... and/or community resources to provide..
Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
... of care review for requested services. Educate providers on utilization and ... and training to support BH services for both PH and BH ... a behavioral-health field, such as..
... health education and value-added, well-being services at the centers and around ... integrated behavioral health, pharmacist, and social services support. The main responsibilities of ... opportunities for automation, analytics,..
