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... NOT LIMITED TO: Maintain high quality, timely and accurate credentialing processes ... processes of medical and allied healthcare professionals per CPC policy and ... issue and physician response Advise..
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 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 ..
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 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 ..
... Kindred at Home RN Clinical Manager in Jacksonville Florida The Clinical ... in Jacksonville Florida The Clinical Manager coordinates and oversees all direct ... effective performance and delivery of..
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..
