- Humana (Denver, CO)
- …put health first** Are you passionate about contributing to the well-being of the Medicare population? Would you like to play an integral and strategic part in the ... of a team? If so, join Humana's Broker Relationship Manager team. Humana has an inclusive and diverse culture...Qualifications** + 2+ years of sales experience in the Medicare industry + Prior experience with public speaking and… more
- Gentiva (Belville, NC)
- …Inspire Excellence. Elevate Hospice Care.** We are seeking a Senior Patient Care RN Manager to join our hospice team. Reporting directly to the Executive Director or ... program by managing patient care activities, supervising clinical staff, and ensuring compliance with all company policies and regulatory standards. **As a Senior… more
- Humana (Richmond, VA)
- …help us put health first** Humana Healthy Horizons in Virginia is seeking a Manager , Care Management (Maternal-Child Health) who will lead teams of nurses and health ... professionals responsible for maternal and child services care management. The Manager works within specific guidelines and procedures; applies advanced technical… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted ... continued stay and resource use, appropriate level of care and program compliance . Identifies when services no longer meet InterQual/Milliman l criteria, initiates… more
- Houston Methodist (Nassau Bay, TX)
- …weekend days. Acute Care experience preferred. At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively ... continued stay and resource use, appropriate level of care and program compliance . Identifies when services no longer meet InterQual/Millman l criteria, initiates… more
- Gentiva (Auburndale, MA)
- …strategic oversight? If so, you could be the next Hospice Patient Care Manager Senior on our team. At Gentiva Hospice, we're dedicated to providing compassionate ... patients live with dignity and comfort. As a Senior Patient Care Manager , you'll help guide branch-level clinical operations, oversee direct patient care activities,… more
- AssistRx (Kansas City, MO)
- …privacy of patient and customer data. DUTIES AND RESPONSIBILITIES: + Assists the Compliance Manager with performing internal reviews, research and/or audits to ... additional quality checks before document finalization. + Assists the Compliance Manager in the review and management...the review and management of third-party audits. + Verifies compliance with insurer rules, Medicare , Medicaid, HIPAA,… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical)...LA Care's Policies & Procedures that meet Centers for Medicare and Medicaid Services (CMS), the California Department of… more
- Humana (Topeka, KS)
- …part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs ... resources appropriate for the care and wellbeing of members. The Care Manager , Telephonic Nurse 2 work assignments are varied and frequently require interpretation… more
- Fallon Health (Lowell, MA)
- …product regulatory requirements and Program policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more