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... drug manufacturers and providers. The Director, Pharmacy Clinical Formulary and Medical Strategies requires ... specialty to develop and/or implement clinical strategies to mitigate cost while ... medical drug strategies...
Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a ... teams that report to this Associate director will assist in identifying 'NEW' ... industry. You will partner with Clinical,..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Louisville Kentucky ... in Louisville Kentucky Description The Associate Director, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The..
Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while providing clinical support for internal stakeholders. Utilizes ... and improve health outcomes. The Associate Director,..
Job Information Humana Associate VP, Clinical Pharmacy (Remote) in Louisville Kentucky ... in Louisville Kentucky Description The Associate VP, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while..
... Medicare Appeals and Grievance Medical Director in Louisville Kentucky Description The ... Louisville Kentucky Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical..
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 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 Associate Director, Quality Assurance for Humana/Your Home ... In Home Wellness Assessments. The Associate Director, Quality Assurance requires a solid ... and coding, organizational capabilities and clinical care..
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,..
... Stars organization is seeking an Associate Director of Strategy and Organizational Enablement ... business issues and opportunities. The Associate Director will lead a team of ... and expanding quality..
... 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's Applied Clinical Informatics team needs your clinical, business and analytics acumen to ... acumen to solve for the healthcare challenges of today. The Applied ... challenges of today...
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 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 Nationwide Associate Director, Utilization Management Nursing in Louisville ... in Louisville Kentucky Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the .....
Job Information Humana Corporate Medical Director, Healthcare Quality Reporting & Improvement in ... Kentucky Description The Corporate Medical Director for Healthcare Quality Reporting and Improvement (HQRI) ... on medical background..
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 relies on fundamentals of CMS ... Line of Business. The Medical Director provides medical interpretation and determinations ... whether services provided by other healthcare professionals are..
Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Louisville ... team that helps translate the clinical into financial to ensure Humana ... external vendors and providers. The Director,..
