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Job Information Humana Medicaid Associate Director, Compliance Nursing in Albany New ... Albany New York Description The Associate Director, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the ... and/or benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... to grow,..
Description The Medical Director actively uses their medical background, ... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG, clinical reference materials,..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director provides medical..
Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical Director provides medical interpretation and determinations ... whether services provided by other healthcare professionals are..
Description The Director, Pharmacy Clinical Pipeline oversees the medical and ... leaders across the Humana enterprise, clinical subject matter experts, analytics, actuaries ... and finance teams. Responsibilities The Director, Pharmacy..
Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Albany ... team that helps translate the clinical into financial to ensure Humana ... external vendors and providers. The Director,..
... Analytics is looking for an Associate Director of Data Science to lead ... future adverse health events. The Associate Director must be able to effectively ... business problems being..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to ... acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team..
Job Information Humana Medical Director - S. Florida in Albany ... New York Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..
Job Information Humana Associate VP, Clinical Pharmacy (Remote) in Albany New ... Albany New York Description The Associate VP, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... resources which may include national clinical guidelines, Humana contract language, Humana ... and determinations, medical necessity criteria, clinical..
Description The Behavioral Health Medical Director responsible for behavioral health care ... operations. The Behavioral Health Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director..
Job Information Humana Associate Director, Technology Solutions in Albany New ... team in the role of Associate Director, Technology Solutions to as a ... training, etc. Reports to a Director..
Job Information Humana Medical Director - Texas in Albany New ... New York Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
... a publicly traded, Fortune 50 healthcare company with a long history ... in the country. Responsibilities The Healthcare Strategy team supports Humana's Medicare ... emphasis on, and partnership with,..
... Medicare Appeals and Grievance Medical Director in Albany New York Description ... New York Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical..
... and Risk Adjustment National Medical Director in Albany New York Description ... Albany New York Description The Healthcare Quality Reporting & Improvement (HQRI) ... and 3) contribute as a..
Description The Medical Director relies on fundamentals of CMS ... per diem requests. The Medical Director provides medical interpretation and determinations ... whether services provided by other healthcare professionals are..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Albany ... Albany New York Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the .....
