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Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description The Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
Description The Medical Coding Auditor Supervisor handles a combination of tasks, including extracting clinical information from a variety of medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, ..
PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP RN 1 is accountable and ..
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 ..
PURPOSE AND SCOPE:Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
... or observations to the nurse supervisor.Evaluate vascular access for patency and ... any unusual findings to nurse supervisor.Obtain necessary pre and post treatment ... Report unusual findings to nurse..
Job Information Humana Referrals Coordinator 2 in Charlotte North Carolina Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied ..
Job Information Humana Supervisor, Credentialing in Charlotte North Carolina Description Responsibilities The Supervisor, Credentialing Operations is responsible for supervising activities associated with certification and recertification of providers in the TRICARE East ..
Job Information Humana Manager of Fraud and Abuse Data Analytics in Charlotte North Carolina Description Responsibilities The Manager of Fraud and Abuse Data Analytics will be responsible for the supervision of ..
WalgreensnJob DescriptionWhere state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience. Serves as a full-time certified pharmacy ..
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 ..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... Charlotte North Carolina Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
Position Number: 012080 Department: Counseling & Health Serv (Adm) Employment Type: Permanent - Full-time Months Per Year: 12 Essential Duties and Responsibilities: Overall operation and administration of the lab including compliance ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description The Care Delivery Tele Sales Supervisor supports and develops a team of Care Delivery Tele Sales Agents. The Care Delivery Tele Sales Supervisor provides timely and effective support to assist ..
Job Information Humana Director, Informatics in Charlotte North Carolina Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights ..
