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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 ..
Job ID 21000M4CAvailable Openings 1PURPOSE AND SCOPE: Supports the training and education of employees based in company facilities and programs within an assigned geographical area. Delivers standardized, competency based, training and ..
... direction of a RN in compliance with the state's Nurse Practice ... any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, ... manager(s), other members of the..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Huntington West Virginia Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts ..
TRS Healthcare is seeking an experienced Emergency ... 13 weeks Pay: $2666.16/Week TRS Healthcare is seeking a Registered Nurse ... Life Support certification About TRS Healthcare: TRS Healthcare is a..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own. Connect with your goals and change ..
PrimeCare Medical of West Virginia, Inc. has an exciting LPN opening in our medical department at the Western Regional Jail in Barboursville, WV. $2,500 Sign On Bonus!nCorrectional nursing provides a challenging ..
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..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Job ID 21000N6WAvailable 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 Humana Healthy Horizons in Ohio is seeking Managers of Care Management (Physical Health & Behavioral Health) who will lead our physical or behavioral health care management operations and staff to ..
Job Information Humana Quality Improvement Coordinator in Huntington West Virginia Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. ..
... and other members of the healthcare team to interpret, adjust, and ... delivery of patient care in compliance with standards outlined in the ... philosophy. Adheres to the FMCNA..
Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
