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Description The Care Management Support Assistant 3 contributes to administration of ... members. The Care Management Support Assistant 3 performs advanced administrative/operational/customer support ... Responsibilities The Care Management Support Assistant..
Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review of ..
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 Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..
Job Information Humana Care Manager, Telephonic Nurse 2-Remote (Eastern Standard Time) in Charleston West Virginia Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs ..
Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of ..
Description The Utilization Management Nurse 2 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 ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. ..
... honor of working with dedicated healthcare professionals that make a positive ... impact in aiding those needing healthcare services across the U.S. every ... our focus in assisting remarkable..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..
Description The Senior Quality Improvement Professional will focus organizational efforts on improving behavioral health (BH)/Substance Use Disorder (SUD) clinical quality performance measures to achieve optimal performance and quality for the Humana ..
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 ..
Job Information Humana Care Manager, Telephonic Nurse 2 Certified Diabetes Care and Education Specialist-Remote-US in Charleston West Virginia Description The Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ..
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 ..
