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Description This is a salaried exempt position with responsibility for utilization management oversight and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in the TRICARE Operations Manual Chapter ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description The Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
Description The Operations Supervisor, Inbound Contacts represents the company ... digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, ... procedures; uses independent judgment requiring analysis of variable..
Description The Supervisor, Health Information Management ensures data ... integrity for claims errors. The Supervisor, Health Information Management works within ... procedures; uses independent judgment requiring analysis of variable factors..
... clean, useable data for further analysis, ensuring CDRL requirements are met ... and process-level measurements. Perform metrics analysis to ensure all case referral ... requested by his or her..
Description The Supervisor, 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 Supervisor, Pre-Authorization ..
RN—ClinicalAbout this role: As a Dialysis Clinic Registered Nurse (RN) with Fresenius Medical Care, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing ..
Description The Supervisor, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The Supervisor, Compliance Nursing works within thorough, ... procedures; uses independent judgment requiring analysis of variable factors..
OverviewnThe System Healthcare Analyst, Controlled Substance Accountability: Audit ... investigation activities plus aggregation and analysis of metrics data for the ... duties provided by the System Supervisor for Controlled Substance..
Job Information Humana Supervisor, Care Management Support in Louisville ... in Louisville Kentucky Description The Supervisor, Care Management Support contributes to ... and wellbeing of members. The Supervisor, Care Management..
Description The Director HEDIS Production and Quality Analytics takes the lead in driving success for key quality measures development and analytic reporting functions that support Humana Military clinical quality strategies, including ..
PURPOSE AND SCOPE:Knowledgeable, developing intermediate level technician performing normal functions under general supervision. Performs scheduled and unscheduled semi-routine repair, maintenance activities and operational condition of all medical equipment, water systems and ..
Description The Supervisor, Care Management Support contributes to ... and wellbeing of members. The Supervisor, Care Management Support works within ... procedures; uses independent judgment requiring analysis of variable factors..
... supervision, uses independent judgment requiring analysis of variable factors and determining ... requested by his or her supervisor, consistent with the purpose of ... Qualifications 3 plus years of..
... a long-term care facility The Supervisor, Care Management Support will lead ... and wellbeing of members. The Supervisor, Care Management Support works within ... procedures; uses independent judgment requiring..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Louisville Kentucky Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Description The Medical Coding Auditor Supervisor handles a combination of tasks, ... records. The Medical Coding Auditor Supervisor's work assignments are varied and ... auditor, the Medical Coding Auditor Supervisor..
Louisville Call Mara at (888) 796-6556 for more information! Field Services Engineer / Maintenance - Imaging Engineer About Us At Alliance Radiology, our team members focus on transforming the patient experience ..
PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP ..
Job Information Humana Care Management Supervisor (Prescription Assistance Program)- CenterWell-Remote in ... in Louisville Kentucky Description The Supervisor, Care Management leads teams of ... and wellbeing of members. The Supervisor,..
... requested by his or her supervisor, consistent with the purpose of ... Public Health Administration, Public Policy, Healthcare Economics, Business or related field ... expertise in population health, data..