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Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..
... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... in accordance with all legal, compliance, and regulatory requirements and programs. ... all requirements of the FMCNA..
... company-specific policy and procedures, applicable healthcare standards, governmental laws, and regulations. ... to treatment to the Clinical Manager and the Participates in the ... are provided to patients in..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Job ID 21000MOCAvailable Openings 1DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient’s future—as well as your own. Connect with ..
... to support diagnosis and home healthcare orders. Provide input to care ... Specialist, Director Clinical Management, and/or Manager Clinical Practice) of patient’s acceptance, ... deliverables. Abide by all operational..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
... direction of a RN in compliance with the state's Nurse Practice ... any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, ... contact with patients, physicians, clinical..
Description Senior Compliance Professional ensures compliance with governmental requirements as they ... Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities The Senior Compliance..
