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Description The Clinical Pharmacy Lead for Pharmacy trend will be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual ..
Job Information Humana Medical Director - S. Florida in Portland Maine Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Medical Director - National Medicare Team in Portland Maine Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
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 ..
Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..
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, ..
Job Information Humana FP&A Lead, Medicaid Market in Portland Maine Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
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 ..
Job Information Humana UM Medical Director - Conviva in Portland Maine Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
New: OB/GYN Opportunity - Beautiful Northern Maine!! The practice is designated as a Federally Qualified Health Center, providing enhanced access to health care services for all members of the community, and ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
ADDITIONAL LOCATIONS: Portland, ME, Saco, ME, Buxton, ME, Scarborough, ME PRIMARY LOCATIONS:ME, Gorham, 298 New Portland Road, 4038 REQUISITION ID:166914 POSITION OVERVIEW $5000 SIGN ON BONUS FOR QUALIFIED CANDIDATE Invest in ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
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 ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
... ongoing updates on Company’s home healthcare service, specialty, and/or product offerings ... to support diagnosis and home healthcare orders. Provides input to care ... location clinical staff (e.g. Intake..
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 ..
Job Information Centerwell Healthcare Account Executive in Kennebunk Maine ... Maine As a Home Health Specialist , you will: Call on ... Required Experience/Skills: Bachelor's degree in Marketing, Business, or..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..
