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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 ..
... philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory ... procedures, and training and in compliance with regulations set forth by ... the FMCNA commitment to the..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are ... courses of action. Responsibilities The Quality Compliance Professional 2..
Job Information Humana Care Manager, Licensed Behavioral Health Professional or Registered Nurse in Lima Ohio Description The Field Care Manager, Behavioral Health 2 (Care Manager, Behavioral Health) assesses and evaluates member's ..
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). ..
... care, services, and supports in compliance with Ohio Department of Medicaid ... policies and procedures to ensure compliance with state and federal requirements ... to support the delivery of..
Job Information Humana Care Manager, Registered Nurse, RN - Maternity, L&D, Mother Baby in Lima Ohio Description The Field Care Manager assesses and evaluates member's needs and requirements to achieve and/or ..
Job Information Humana Quality Improvement Coordinator in Lima Ohio ... in Lima Ohio Description The Quality Improvement Coordinator 3 assists in ... assists in administering and monitoring quality improvement and..
Description The Senior Quality Compliance Nurse Professional is an integral ... integral part of the Ohio Quality Improvement Department. This role will ... sensitive projects. Responsibilities The Senior Quality Compliance..
