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Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager,..
Description Responsibilities The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers..
Description Full-Time Remote, Telephonic RN opportunity. Humana Care Support is a division of Humana that is dedicated to helping adults remain independent in their homes. Our nurses are titled Care..
Genesis HealthCare is one of the leading providers of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing..
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,..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the..
Job Information Humana Care Manager, Telephonic Nurse 2 - WAH Nationwide in Montpelier Vermont Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members'..
Description The Intern - Care Manager, Registered Nurse, RN performs varied activities moderately complex administrative/operational/member support and semi-routine assignments to support the Florida Medicaid team. Responsibilities The Intern - Care..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Montpelier Vermont Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be..
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...
Description Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that..
Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The..
Description The Weekend Telephonic 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..
Genesis HealthCare is a leading provider of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how care..
Up to a $3,000 Sign on Bonus for full time! BenefitsHealth, Dental, Vision, Company-paid life insurance, 401K, Paid Time OffEmployee Assistance Program to support mental healthEmployee Foundation to financially assist..
Description The Senior Market Consultation/Partnership Professional promotes and improves the quality and measurement of care delivery programs with a market(s). The Senior Market Consultation/Partnership Professional work assignments involve moderately complex..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that..
$10,000 Sign On Bonus for Full Time !! Genesis is a leading provider of post-acute healthcare services from short-term to long-term care and a wide variety of living options and..
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 for Humana's Kentucky Medicaid Plan. The..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general..
Description The Utilization Management Nurse 1 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 1 work..
Description Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and..
