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... Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania Description The ... Description The Associate Director, Compliance Nursing reviews utilization management activities and ... abuse. The Associate Director, Compliance..
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 ..
Job Information Humana Senior Clinical Recruiter in Pittsburgh Pennsylvania Description ... Pittsburgh Pennsylvania Description The Senior Clinical Recruiter recruits qualified applicants for ... determines marketing approach. The Senior Clinical Recruiter..
... RN, you will enter our Clinical Advancement Program (CAP) to grow ... in CAP, you will develop clinical leadership skills, derive greater career ... for your experience, knowledge, and..
... applicable state) responsible for providing clinical expertise in any of the ... any of the following areas: Clinical Interface/Liaison (clinical problem solver with facilities, providers, ... interpretation, program definition..
... brand association as a credible clinical leader through clinical engagement activities. Provides the organization ... activities. Provides the organization with clinical insights that improve the ability ... meet emerging..
Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..
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 Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere ... Pennsylvania Description The Supervisor, Pre-Authorization Nursing will be managing the team ... appropriate stakeholder. The Supervisor, Pre-Authorization Nursing..
... 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 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 ..
... 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..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Pittsburgh Pennsylvania Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
... 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 Clinical Business Professional is a clinical partner to the Commercial Product ... Product Strategy team. The Senior Clinical Business Professional work assignments involve ... at home anywhere..
... 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..
... 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..
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 ..
... Humana RN, Senior Stars Improvement, Clinical Professional in Pittsburgh Pennsylvania Description ... a RN, Senior Stars Improvement, Clinical Professional who will be responsible ... Program. The Senior Stars Improvement,..
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..