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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 ..
... coordinates services within the multidisciplinary clinical system resulting in exceptional patient ... appointments and referrals and assumes clinical nursing responsibilities associated with the Yale ... Center. 1.1 Serves as..
... 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..
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 Senior Clinical Recruiter in Bridgeport Connecticut Description ... Bridgeport Connecticut Description The Senior Clinical Recruiter recruits qualified applicants for ... determines marketing approach. The Senior Clinical Recruiter..
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 ..
... 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..
Description The Senior Nursing Educator plans, directs, coordinates, evaluates, ... and education programs for professional nursing personnel. The Senior Nursing Educator work assignments involve moderately ... variable factors. Responsibilities The..
... 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 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 ..
... 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 Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
... Humana RN, Senior Stars Improvement, Clinical Professional in Bridgeport Connecticut Description ... a RN, Senior Stars Improvement, Clinical Professional who will be responsible ... Program. The Senior Stars Improvement,..
... entry level designation into the Clinical Advancement Program (CAP). This position ... Care policy procedures standards of nursing practice state and federal regulations.Performs ... and with guidance from the..
Description Humana's recently created Clinical Resource Team is looking to ... Do you have a solid clinical background in acute care? Well, ... Auditor opportunity with Humana. Performs clinical audit/validation..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Connecticut Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
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..
... Humana Medicaid Associate Director, Compliance Nursing in Bridgeport Connecticut Description The ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Bridgeport Connecticut Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, ... plan. The Senior Provider Engagement, Clinical Professional work assignments involve moderately ... Responsibilities The Senior Provider Engagement, Clinical..
