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Description The RN, Compliance Nurse 2 reviews utilization management ... waste, and abuse. The RN Compliance Nurse 2 work assignments are ... of action. Responsibilities The RN Compliance Nurse 2..
... all utilization reviews are in compliance with the terms of the ... procedural and Florida Agency for Healthcare Administration (ACHA). Ensure adoption and ... contract changes and/or updates. Maintain..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... with physicians, team members, Quality, Compliance, partners at Enterprise and leadership ... and productivity requirements. Assist with Regulatory Audits by performing first coding ... work experience with Coding and/or..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires ..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care ..
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..
... to ensure documentation is in compliance with regulatory agencies and requirements of third-party ... are completed timely and in compliance with Medicare regulations. Coordinates communication ... policies and procedures..
