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Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Job Information Humana Senior Contract Tools, Education, Processes Professional - ... Springs Colorado Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..
SCOPE The Behavioral Health Clinical Director is primarily responsible for leading and directing the organizations medically necessary services that are referred to the organization. This position will supervise the Behavioral Health ..
Job Information Humana Medical Director - Florida Medicaid in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Job Information Humana Medical Director - National Medicare Team in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work ..
Job Information Humana FP&A Lead, Medicaid Market in Colorado Springs Colorado Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
... market contracting teams to influence specialist contract terms that align with Service ... in close coordination with PCP Contract Load, Capitation Rates, Payments, and ... Adjustments teams to ensure..
Job Information Humana UM Medical Director - Conviva in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Colorado Springs Colorado Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
