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Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..
... procedures, and training and in compliance with regulations set forth by ... PCT’s. Collaborates with the Clinical Manager and Education Coordinator in driving ... are incorporated into training, including..
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 ..
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 ..
... Kindred at Home RN Clinical Manager in Kalamazoo Michigan The Clinical ... in Kalamazoo Michigan The Clinical Manager coordinates and oversees all direct ... to ensure documentation is in..
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). ..
... direction of a RN in compliance with the state's Nurse Practice ... any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, ... contact with patients, physicians, clinical..
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..
