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... commitment to the Quality Enhancement Program (QEP) and CQI Activities, including ... PCT’s. Collaborates with the Clinical Manager and Education Coordinator in driving ... Clearance Monitoring (OLC), Adequacy Monitoring..
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 ..
... training objectives. Develop/implement a conditioning/rehabilitation program consistent with physician’s Plan of ... and revising the therapy treatment program and Plan of Treatment. Provide ... to the patient's physician, Clinical..
... Investigator will serve as Humana's Program Integrity Officer, who will oversee ... waste, and abuse (FWA) compliance program to prevent and detect potential ... in Louisiana to increase Medicaid..
Description Humana Healthy Horizons in Louisiana is seeking Behavioral Health Liaisons to join our growing team. The Behavioral Health (BH) Liaisons will be responsible for ensuring connection, coordination, outreach, education, and ..
... results, including growth, patient retention, program costs, operational methods, scheduling, and ... costs, operational methods, scheduling, and staffing. Directs activities related to the ... loss management of the assigned..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management Nursing who will utilize clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..
Description Humana Health Horizons in Louisiana is seeking a Behavioral Health (BH) Children's System Administrator (Care Management Behavioral Health Lead) who will advise on program features to reach members and drive ..
... individual needs. Monitor and maintain staffing levels to meet care and ... years' experience working in the healthcare setting. Minimum two (2) years ... of Humana's Tuberculosis (TB) screening..
... in Louisiana is seeking a Manager, Care Management (Behavior Health) who ... individual needs. Monitor and maintain staffing levels to meet care and ... years' experience working in the..
... Louisiana is seeking a RN, Manager of Care Management to lead ... staff for the Moms First program, to ensure timely and culturally-competent ... individual needs. Monitors and maintains..
... in Louisiana is seeking a Manager, Utilization Management (Behavioral Health) who ... and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health applies ... utilization management. Monitor and maintain..
