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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 Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania ... in Pittsburgh Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The..
Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Pittsburgh ... team that helps translate the clinical into financial to ensure Humana ... external vendors and providers. The Director,..
Job Information Humana Associate Director, Technology Solutions in Pittsburgh Pennsylvania ... team in the role of Associate Director, Technology Solutions to as a ... training, etc. Reports to a Director..
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..
... leader. If you haven't considered Healthcare before, read on as we ... as we think you should. Healthcare Experience is NOT required. For ... years, DaVita has demonstrably improved..
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..
... America DaVita is seeking a Clinical Coordinator who is looking to ... etc.)* Ensure you and your clinical team are delivering the highest ... Charge RN readiness approval by..
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 ..
Job Information Humana Associate VP, Clinical Pharmacy (Remote) in Pittsburgh Pennsylvania ... in Pittsburgh Pennsylvania Description The Associate VP, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while..
... Medicare Appeals and Grievance Medical Director in Pittsburgh Pennsylvania Description The ... Pittsburgh Pennsylvania Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical..
... 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..
... Responsibilities: Field Medical Leadership Support Director MSL Team Lead in deployment ... demonstrating an excellent scientific and clinical knowledge as well as an ... of affiliate and field organization):..
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 ... per diem requests. 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,..
Job Information Humana Medical Director - Texas in Pittsburgh Pennsylvania ... Pittsburgh Pennsylvania Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Pittsburgh ... in Pittsburgh Pennsylvania Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the .....
Job Information Humana Medical Director - S. Florida in Pittsburgh ... Pittsburgh Pennsylvania Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..
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 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..