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Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
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Description The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Understands alternate payment structures and quality incentives for ..
Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
Job Information Humana Clinical Provider Quality Improvement Field RN - Orange, Osceola, Polk County, FL in Apopka Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and ..