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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 ..
... leadership. Our Department of Defense Contract requires U.S. citizenship for this ... Qualifications Our Department of Defense Contract requires U.S. citizenship for this ... Qualifications 2 plus years of..
Job Information Humana Medical Director - National Medicare Team in Portsmouth New Hampshire Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work ..
... 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..
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 - ... New Hampshire Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..
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 ..
Hueman is hiring Nurse Practitioners to complete Health Risk Assessments (HRAs) in the home of Medicare and Medicaid members in and around Hampton, NH. This position offers certified Nurse Practitioners the ..
Job Information Humana UM Medical Director - Conviva in Portsmouth New Hampshire 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 Job Description Summary 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 ..
Job Information Humana Medical Director - Florida Medicaid in Portsmouth New Hampshire 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 Portsmouth New Hampshire Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
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, ..
Hueman is currently hiring Nurse Practitioners to complete Health Risk Assessments (HRAs) in the home of Medicare and Medicaid members in and around Methuen, Massachusetts. This position offers certified Nurse Practitioners ..
Job Information Humana FP&A Lead, Medicaid Market in Portsmouth New Hampshire Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
