THE LARGEST COLLECTION OF HEALTHCARE JOBS ON EARTH
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... The Home Compliance & Risk Management Lead contributes to the success ... Home Solutions teams within the Healthcare Services organization. As the Compliance ... As the Compliance & Risk..
... include data entry into medical management systems, assigning appropriate providers as necessary, ... Autism Services Navigator (ASN), Utilization Management professional or Manager for clinical ... into MSR and other..
Description The Problem, Incident and Event Management Engineer 2 monitors trends in incidents and system issues and helps drive technical support teams to recover services during periods of service disruption or ..
... purpose is to provide care management program support resources to physicians, ... physicians, physician groups, and integrated healthcare delivery systems throughout the country. Healthcare isn't just about health anymore...
Description The Care Management Support Assistant 3 contributes to ... contributes to administration of care management. Provides non-clinical support to the ... wellbeing of members. The Care Management Support Assistant..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills ... determinations. The Associate Director, Utilization Management Nursing requires a solid understanding ... process. The Associate Director, Utilization Management..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
Description The Utilization Management Behavioral Health Professional 2 utilizes ... benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... a Compact State The Utilization Management Behavioral Health..
... Director, Problem, Incident and Event Management drives technical support teams to ... Director, Problem, Incident and Event Management requires a solid understanding of ... Director, Problem, Incident and Event..
Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
... care facility The Supervisor, Care Management Support will lead a team ... contributes to administration of care management. Provides non-clinical support to the ... of members. The Supervisor, Care..
Job ID 21000HL6Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
... look for a Senior Business Systems Analyst to join working remote ... the US! The Senior Business Systems Analyst performs analysis of business, ... requirement specifications. The Senior Business..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
... accuracy of formularies and utilization management (UM) criteria in the Formulary ... Collaborates with other pharmacists and healthcare professionals in a team environment ... an expert in Humana's formulary..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral ... involves processing referrals into medical management system with emphasis on accuracy ... answer provider/beneficiary inquiries. The Care Management Support..
... the Associate Director, IT Project Management, you will use your background ... background and experience in program management to lead and manage a ... The Associate Director, IT Project..
... and possible participation in care management. The clinical scenarios predominantly arise ... health, or disease or care management. Medical Directors support Humana values, ... whether services provided by other..
Job ID 21000HLPAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... administration determinations. The Manager, Utilization Management Nursing works within specific guidelines ... goals. Responsibilities The Manager, Utilization Management Nursing..
