Associate Director Healthcare Clinical Jobs in Albuquerque

Job Information Humana Medicaid Associate Director, Compliance Nursing in Albuquerque New ... Albuquerque New Mexico Description The Associate Director, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The..

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,..

Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Albuquerque ... team that helps translate the clinical into financial to ensure Humana ... external vendors and providers. The Director,..

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 Nationwide Associate Director, Utilization Management Nursing in Albuquerque ... Albuquerque New Mexico Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the .....

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..

... 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..

Job Information Humana Associate VP, Clinical Pharmacy (Remote) in Albuquerque New ... Albuquerque New Mexico Description The Associate VP, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while..

... 40) market leader in integrated healthcare with a clearly defined purpose ... experience and vitality of the associate community. Through offerings anchored in ... we are seeking an accomplished..

Job Information Humana Medical Director - S. Florida in Albuquerque ... New Mexico Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..

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 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,..

... and Risk Adjustment National Medical Director in Albuquerque New Mexico Description ... Albuquerque New Mexico Description The Healthcare Quality Reporting & Improvement (HQRI) ... and 3) contribute as a..

Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director will provide..

Job Information Humana Associate Director, Technology Solutions in Albuquerque New ... team in the role of Associate Director, Technology Solutions to as a ... training, etc. Reports to a Director..

Description The Medical Director actively uses their medical background, ... resources, which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials,..

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 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..

... Medicare Appeals and Grievance Medical Director in Albuquerque New Mexico Description ... New Mexico Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical..

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 Medical Director - Texas in Albuquerque New ... New Mexico Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..

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..

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..