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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..
... Responsibilities 1. From the Epic Analysis Needed work queue, analyzes the ... the assigned discharge in the Analysis needed work queue and open ... Monitors and maintains the Epic..
... successful. 4. Assists in the analysis and interpretation of business unit ... requests. Will meet with site supervisor and clinicians to review budget ... meet measures. 7. Prepares staffing..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
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..
Description Responsibilities The Senior Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. Translates business needs into technical systems solutions. Integrates ..
... 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..
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 ..
Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, ..
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 ..
Description The Care Management Support Assistant 2 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision ..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Bridgeport Connecticut Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
... Lead role will assist the Supervisor in oversight & monitoring of ... requested by his or her supervisor, consistent with the purpose of ... company objectives . Required Qualifications..
... 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..
... recommendations to patients/families and the healthcare team regarding medical nutrition therapy ... feedback and as observed by supervisor. 2. Demonstrates effective organizational skills ... individual learning; discusses solutions with..
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 ..
... 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..
Job ID 21000JSKAvailable Openings 1PURPOSE 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. ..
... to complex issues where the analysis of situations or data requires ... to complex issues where the analysis of situations or data requires ... 25% Perform Project Planning and..
Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..
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 ..
