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Job ID 21000L1TAvailable Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
... leverages its advanced knowledge of data, modeling, optimization, and tools. Applies ... that improve the outcomes and quality of the programs we offer. ... problems. Understands and analyzes complex..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
... Humana members to make informed healthcare decisions. Our key goal is ... help our members obtain high quality affordable healthcare while keeping our provider networks ... (cost) & Effectiveness..
... effective performance and delivery of quality home care services, and is ... Utilization Review staff relative to data tracking for performance review and ... raise the bar on home..
