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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Supervisor, Care Management Support contributes to administration of care ... of care management. Provides non-clinical support to the assessment and evaluation ... members. The Supervisor, Care Management Support..
... facility The Supervisor, Care Management Support will lead a team of ... a team of 16-22 care support professionals and contributes to administration ... of care management. Provides non-clinical..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts ... Qualifications Bachelor's degree or significant..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
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 Care Management Support Specialists contribute to the administration ... management. The CMSS provides non-clinical support to the assessment and evaluation ... and wellbeing of members. The Support Specialist performs..
... is looking for an experienced Healthcare Investigator to join its industry ... Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts ... areas Bachelor's degree or significant..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Location: Dover, DE Department: ABA Services Posted: 05/25/2023 Location Name: Delaware Wage: TBD Come join a team of passionate therapists providing excellent pediatric therapy to children throughout the United States! Achieve ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Location: Dover, DE Department: ABA Services Posted: 05/25/2023 Location Name: Delaware Wage: TBD Shift: 9:00am-5:30pm Monday Through Friday Some Weekends Come join a team of passionate therapists providing excellent pediatric therapy ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
... medical literature, while providing clinical support for internal stakeholders. Utilizes broad ... senior leadership on key metrics Support clinical research integration activities with ... other leaders throughout HPS to..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..
Description Job Description Summary The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Dover Delaware Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
... Job Description Summary Care Management Support Specialists contribute to the administration ... management. The CMSS provides non-clinical support to the assessment and evaluation ... and wellbeing of members. The..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
