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Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
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 ..
... social determinants and obtaining timely healthcare. The Lead Medical Director provides ... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... to BH..
... whether services provided by other healthcare professionals are in agreement with ... of services provided by other healthcare professionals in compliance with review policies, procedures, and ... with a..
Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Riverton Wyoming Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..
... is looking for an experienced Healthcare Investigator to join its industry ... a thorough investigation to maintain compliance with Humana and governmental requirements ... external partners (Law Enforcement, Legal,..
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 ..
Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..
