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Description Humana is seeking a Genetic Counselor to assist in the detecting and investigation of potential fraud and provide clinical guidance to the Special Investigators handling the cases. This is an ..
Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description The Senior Quality Compliance Nurse Professional is an integral part of the Ohio Quality Improvement Department. This role will collaborate with internal and external customers to complete fast-paced and time ..
Description The Care Management Support Assistant 2 contributes to administration of Care Management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
