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Description The Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization Behavioral ..
... Humana Medicaid Associate Director, Compliance Nursing in Troy Michigan Description The ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
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 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 Utilization ..
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 ..
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Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 in Troy Michigan Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and ..
... leverage a broad range of nursing skills and knowledge. * Oversee ... Requirements: * Associates Degree in Nursing (A.D.N) from accredited school of ... (A.D.N) from accredited school of..
Job Information Humana Pre-Authorization Registered Nurse, RN, 1 in Troy Michigan Description The Pre-Authorization Nurse 1 reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves ..
Job Information Humana Clinical Auditor Registered Nurse Care Management or Utilization Management in Troy Michigan Description Humana Healthy Horizons in Ohio is seeking a Utilization and Case Management Clinical Auditors. This ..
Description The Intern - Care Manager, Registered Nurse, RN performs varied activities moderately complex administrative/operational/member support and semi-routine assignments to support the business needs. Responsibilities The Intern - Care Manager, Registered ..
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 ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Troy Michigan Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Description CarePlus is seeking a Nursing Educator 2 who will plan, direct, coordinate, evaluate, develop, and/or deliver training and education programs for professional nursing personnel. The Nursing Educator 2 work assignments ..
Job Information Humana Utilization Management Registered Nurse, RN in Troy Michigan Description The Utilization Management Nurse applies a Person-Centered approach, works within specific guidelines and procedures; applies advanced technical knowledge and ..
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 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, ..
... Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in ... Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... determinations. The..
Job Information Humana Utilization Management Registered Nurse - Remote in Troy Michigan Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services ..
Job Information Humana Senior Compliance Registered Nurse in Troy Michigan Description Humana Healthy Horizons in Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory reporting for Case Management 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. The Utilization Management Nurse 2 work assignments ..
