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Job Information Humana Medicaid Associate Director, Compliance Nursing in Green Bay ... Green Bay Wisconsin 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,..
Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Green ... team that helps translate the clinical into financial to ensure Humana ... external vendors and providers. The Director,..
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 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 fundamentals of CMS ... Line of Business. The Medical Director provides medical interpretation and determinations ... whether services provided by other healthcare professionals are..
... Medicare Appeals and Grievance Medical Director in Green Bay Wisconsin Description ... Bay Wisconsin Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical..
Description iCare is seeking an Associate Director, Medicaid Care Management who will ... who will lead teams of healthcare professionals responsible for care management ... and SSI Medicaid programs. The..
Description iCare is seeking an Associate Director, Medicare Care Management who will ... who will lead teams of healthcare professionals responsible for care management. ... responsible for care management. The..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Green ... Green Bay Wisconsin Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the .....
... 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 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..
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 ..
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..
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..
Job Information Humana Medical Director - Texas in Green Bay ... Bay Wisconsin Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..
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 Associate VP, Clinical Pharmacy (Remote) in Green Bay ... Green Bay Wisconsin Description The Associate VP, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while..