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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 ..
Job Information Humana Clinical Vendor Management Lead - Remote, FL in Jacksonville Florida Description The Clinical Vendor Management Lead works as clinical liaison between vendors and organization. The Clinical Vendor Management ..
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, 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). ..
... 6 people supports the IBA project team on customer acceptance, training ... Responsibilities: As Product Application support manager, your responsibilities will be to: ... Operations/Service, especially the team of..
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 ..
... resources. Maintains focus on all healthcare quality and affordability initiatives (HCQAI’s). Established ... raise the bar on home healthcare Kindred at Home, soon becoming ... of compassionate clinicians who..
... SCOPE: Ensure the provision of quality patient care to all hospitalized ... customer service philosophy to ensure quality service while maintaining a high ... to reduce costs and maintain..
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 ..
