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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 Dover Delaware Description The ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
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 ..
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 ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Dover Delaware Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
... entry level designation into the Clinical Advancement Program for Registered Nurses. ... Care policy, procedures, standards of nursing practice, state and federal regulations. ... under the direction of the..
... shifts (outpatient only) *Tuition reimbursement *Clinical Advancement Program (CAP)- gain knowledge/increase ... entry level designation into the Clinical Advancement Program (CAP). This position ... Care policy procedures standards of..
... 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..
... assist with administrative direction for clinical practice and efficient care delivery. ... based on needs of the clinical area and requirements for off ... and facilitates a culture of..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Delaware Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
... Humana RN, Senior Stars Improvement, Clinical Professional in Dover Delaware Description ... a RN, Senior Stars Improvement, Clinical Professional who will be responsible ... Program. The Senior Stars Improvement,..
... limited late shifts (outpatient only)*Tuition reimbursement*Clinical Advancement Program (CAP)- gain knowledge/increase ... entry level designation into the Clinical Advancement Program (CAP). This position ... Care policy procedures standards of..
Job Information Humana Senior Clinical Recruiter in Dover Delaware Description ... Dover Delaware Description The Senior Clinical Recruiter recruits qualified applicants for ... determines marketing approach. The Senior Clinical Recruiter..
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 ..
... shifts (outpatient only) *Tuition reimbursement *Clinical Advancement Program (CAP)- gain knowledge/increase ... RN, you will enter our Clinical Advancement Program (CAP) to grow ... in CAP, you will develop..
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..
... 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..
... 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..