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Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
... procedural and Florida Agency for Healthcare Administration (ACHA). Ensure adoption and ... compliance with Florida Agency for Healthcare Administration (ACHA), NCQA, Department of ... Bachelor's Degree in health services,..
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 ..
Description The Manager, Risk Adjustment oversees coding educators ... Adjustment oversees coding educators and quality assurance audits of medical records and ... and Medicaid Services (CMS). The Manager, Risk Adjustment..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires ..
Job Information Centerwell RN Clinical Manager in Tallahassee Florida The Clinical ... in Tallahassee Florida The Clinical Manager coordinates and oversees all direct ... effective performance and delivery of quality..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care ..
... access, lowering costs and improving quality of care. Millions of times ... addition to supporting the Pharmacy Manager in leading and directing your ... Practice • Regulatory Requirements •..
