Associate Director Healthcare Clinical Jobs in Rhode Island

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 Newport Rhode ... Newport Rhode Island 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,..

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 fundamentals of CMS ... Line of Business. 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 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..

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

... Medicare Appeals and Grievance Medical Director in Newport Rhode Island Description ... Rhode Island Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical..

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

Job Information Humana Medical Director - Texas in Newport Rhode ... Rhode Island 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 Newport Rhode ... Newport Rhode Island Description The Associate VP, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while..

... the nations' leading provider of healthcare services from short-term to long-term ... of living options and professional clinical services. We are changing how ... turn over responsibility to 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..

... and Risk Adjustment National Medical Director in Newport Rhode Island Description ... Newport Rhode Island Description The Healthcare Quality Reporting & Improvement (HQRI) ... and 3) contribute as a..

Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Newport ... Newport Rhode Island Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the .....

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 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 responsible for behavioral health care ... operations. The Behavioral Health Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director..

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 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 Medical Director - S. Florida in Newport ... Rhode Island 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,..