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Description The Associate Director, Care Management leads teams of ... for care management. The Associate Director, Care Management requires a solid ... across department(s). Responsibilities The Associate Director, Care Management..
Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
Description The Director, Health Services utilizes clinical nursing skills to support the coordination, ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... function or segment. Responsibilities..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... benefit administration determinations. The Associate Director, Utilization Management Nursing requires a solid understanding of..
Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
Description JOB SUMMARY Responsible for providing effective clinical record reviews inclusive of medical necessity request/ denials, complaints, external medical records request, mortality and morbidity reviews. Monthly complaint log audits services. Participate ..
... accountability for the management of nursing and home health aide functions ... care. Promotes positive relationships between nursing, home health aide employees, physicians ... to Two years of pediatric..
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 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 ..
Description The Senior Nursing Quality Outcomes Coordinator will partner ... leaders within the Division of Nursing to oversee or lead quality ... will work in collaboration with nursing leadership teams..
... the Chief Medical Officer (CMO)/Medical Director to review PA requests. The ... medical equipment, outpatient therapies, skilled nursing facility therapies, and all outpatient ... for forwarding to the CMO/Medical..
... and research. ED / ER Nursing Director - Trauma Emergency Room (Full ... continually improve the profession of nursing and patient care within the ... Hospitals Service Excellence Standards...
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Washington District Of Columbia ... Of Columbia Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support..
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 on ..
Description Job Summary 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 ..
Description The Director, Health Services Nursing serves as the strategic leader ... building out clinical capabilities. The Director will be responsible for driving ... and financial stewardship Responsibilities The Director,..
... accountability for the management of nursing and home health aide functions ... care. Promotes positive relationships between nursing, home health aide employees, physicians ... a fully accredited school of..
... EMTC reports to the Chief Nursing Officer, Vice President of Nursing and operates within a multidisciplinary ... at both locations. A Medical Director for each campus oversees day .....
... operations. You will develop the nursing and clinical department goals, objectives, ... and implementing the Standards of Nursing Practice and the clinical operations ... of experience at a senior..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Washington District Of Columbia ... Of Columbia Description The Associate Director, Compliance Nursing reviews utilization management activities and ... waste, and..
Description Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions. Consumers expect more personalized and holistic experiences from their health partners. Humana's Enterprise Clinical Operating ..
