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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..
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 ..
... in large, complex, and integrated healthcare or payer setting Experience in ... or payer setting Experience in healthcare management and/or operations, Provider Practice/Healthcare or medical center operations Ability .....
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 ..
Job Information Humana Senior Contract Tools, Education, Processes Professional - ... Allen Virginia Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..
Job OverviewUnder guidance, controls the report generation process and provides guidance and support to clients daily or as a specialist on specific products/services.Essential Functionsu2022 Ensures the contract fulfillment to specifications of ..
Job Information Humana Medical Director - National Medicare Team in Glen Allen Virginia Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work ..
... to improve the quality of healthcare for humanity. All full-time university ... here: https://hr.vcu.edu/current-employees/benefits/university-and-academic-professional-benefits/ Summary The Grant Specialist (Specialist) assists the grants administrator in ... administration of sponsored project...
Job Information Humana UM Medical Director - Conviva in Glen Allen Virginia 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 Glen Allen Virginia Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
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 FP&A Lead, Medicaid Market in Glen Allen Virginia Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
Job Information Humana Medical Director - Florida Medicaid in Glen Allen Virginia Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
... 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 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, ..
