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Description The Senior Quality Assurance, Clinical Professional requires being both a ... critical review judgment to make clinical determinations Knowledge of inpatient and ... of 3-5 years of general nursing..
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 ..
... Humana Medicaid Associate Director, Compliance Nursing in Tampa Florida Description The ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
... 2 will work on the clinical research and development team with ... to develop, implement and maintain clinical lab audit concepts. The Nurse ... Nurse Auditor 2 will perform..
Job Information Humana RN Sr. Stars Improvement - Medical Record Review Focus in Tampa Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and management oversight of ..
... Humana RN, Senior Stars Improvement, Clinical Professional in Tampa Florida Description ... a RN, Senior Stars Improvement, Clinical Professional who will be responsible ... Program. The Senior Stars Improvement,..
... patient care while maintaining cost-effective clinical operations in accordance with all ... and administrative policies as the clinical leader, has the authority to ... and regulations. Ensures all FMS..
Description The Nurse Practitioner applies advanced education and clinical competencies to achieve optimal patient outcomes. The Nurse Practitioner works on problems of diverse scope and complexity ranging from moderate to substantial. ..
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 Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Florida Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
Description CarePlus is seeking a Clinical Business Lead who will lead ... Management and Utilization Management. The Clinical Business Lead works on problems ... moderate to substantial. Responsibilities The Clinical..
... The Nurse Auditor 2 performs clinical audit/validation processes to ensure that ... for appropriate change management. Applies clinical and coding experience to conduct ... Nurse (RN) license 3 years..
Job Information Centerwell RN Clinical Manager Home Health Full Time ... Time in Clearwater Florida The Clinical Manager coordinates and oversees all ... care patient services provided by clinical personnel...
Job Information Centerwell RN Clinical Manager Home Health Full Time ... Time in Tampa Florida The Clinical Manager coordinates and oversees all ... care patient services provided by clinical personnel...
... will be responsible for performing clinical audits on medical record documentation ... record documentation for quality and clinical compliance with contract requirements as ... of three (3) years of..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing works within thorough, prescribed guidelines ... approach. Responsibilities The Supervisor, Pre-Authorization Nursing: Completes..
... Information Kindred at Home Tampa Clinical Manager in Tampa Florida The ... Manager in Tampa Florida The Clinical Manager coordinates and oversees all ... care patient services provided by..
Job Information Centerwell RN Clinical Manager in St. Petersburg Florida ... in St. Petersburg Florida The Clinical Manager coordinates and oversees all ... care patient services provided by clinical personnel...
... Information Kindred at Home RN Clinical Manager Home Health Full Time ... FL in Tampa Florida The Clinical Manager coordinates and oversees all ... care patient services provided by..
Job Information Humana Clinical Vendor Management Lead - Remote, ... Port Richey Florida Description The Clinical Vendor Management Lead works as ... Vendor Management Lead works as clinical liaison between..
Job Information Humana Utilization Management Nurse Lead - Remote FL in Tampa Florida Description The Utilization Management Nurse Lead utilizes clinical nursing skills to support the coordination, documentation and communication of ..