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Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied ..
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 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 questions ..
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 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 Manager, ..
Description The Supervisor, 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 Supervisor, Compliance ..
Description The Care Manager, Telephonic Behavioral Health 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 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 Nurse ..
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 responsible ..
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 abuse. ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Montpelier Vermont Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Job Information Humana Bilingual Spanish RN Care Manager--Compact License Required-WAH Nationwide in Montpelier Vermont Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..
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 is ..
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 flexibility ..
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 through ..
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, Compliance ..
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 hinder ..
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' needs ..
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. Responsibilities ..
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 facilitate ..
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 Managers, ..
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 how ..