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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 ..
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 ..
... 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..
Description Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. ..
Job Information Humana Utilization Management Registered Nurse - Remote in Aberdeen South Dakota Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical ..
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 ..
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 ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Aberdeen South Dakota Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the flexibility ..
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, ..
... members' progress toward goals Use nursing judgment to assess and coordinate ... action. Hold an active Compact nursing license and reside in the ... Council of State Boards of..
Description The Behavioral Health Care Manager, Telephonic Nurse, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 in Aberdeen South Dakota Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..
Job Information Humana Utilization Management Registered Nurse, RN 2 in Aberdeen South Dakota Description The Utilization Management Nurse applies a Person-Centered approach, works within specific guidelines and procedures; applies advanced technical ..
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 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 Nurse Advice Line Telephonic Nurse - RN Compact License States Only in Aberdeen South Dakota Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses ..
