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Description The Senior Stars Improvement, Clinical Professional (RN or LPN) responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Senior Stars Improvement, Clinical Professional work ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
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 RN - Provider Clinical Liaison contributes to administration of utilization management. The RN - Provider Clinical Liaison work assignments involve moderately complex to complex issues where the analysis of situations ..
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 ..