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Description This is a salaried exempt position with responsibility for utilization management oversight and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in the TRICARE Operations Manual Chapter ..
Description Humana has a new Claims Research & Resolution Supervisor opening for those in the Green Bay, WI and Louisville, KY areas. The Supervisor manages claims operations that involve customer contact, ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description The Supervisor, Care Management Support 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 wellness ..
Description iCare is seeking an Associate Director, Medicaid Care Management who will lead teams of healthcare professionals responsible for care management for BadgerCare Plus and SSI Medicaid programs. The Associate Director, ..
Description iCare is seeking an Associate Director, Medicare Care Management who will lead teams of healthcare professionals responsible for care management. The Associate Director, Medicare Care Management role requires a solid ..
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 ..
Description The Care Delivery Tele Sales Supervisor supports and develops a team of Care Delivery Tele Sales Agents. The Care Delivery Tele Sales Supervisor provides timely and effective support to assist ..
Job Information Humana Supervisor, Credentialing in Green Bay Wisconsin Description Responsibilities The Supervisor, Credentialing Operations is responsible for supervising activities associated with certification and recertification of providers in the TRICARE East ..
Job Information Humana Director, Informatics in Green Bay Wisconsin Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights ..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..
POSITION FEATURES:Additional Job DescriptionNO previous dialysis experience needed, extensive PAID training is provided!Mainly provide Dialysis treatments at a Green Bay hospitalPURPOSE AND SCOPE:The professional registered nurse Inpatient Services RN CAP 1 ..
POSITION FEATURES:Float RN within the Fox Valley WI areaRN—ClinicalAbout this role: As a Dialysis Clinic Registered Nurse (RN) with Fresenius Medical Care, you will be part of a close-knit, collaborative team ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..
Description The Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... Green Bay Wisconsin Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
