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What You Will Do: General Summary The ROI Coordinator, under direct supervision, oversees the intake and output of all release of information functions, and collaborates with the Director of Front End ..
What You Will Do: Healthcare Info Analyst II Full Time, 8:00am-4:30pm Baltimore, MD We are looking for talented professionals to join our team at University of Maryland Medical Center - Midtown ..
What You Will Do: General Summary Under limited supervision develops, analyzes, reports and interprets complex financial information to assist management in evaluating and executing the organization's business plans in compliance with ..
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 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 ..
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 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, ..
... 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..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Job Information Centerwell RN Admissions Home Health Full Time in Towson Maryland The Clinical Assessment Advisor directly completes and oversees development/ of the plan of treatment as approved by physician, performs ..
... administrative direction, the Transplant Informatics Specialist leads, coordinates and provides support ... these objectives, the Transplant Informatics Specialist oversees communication and coordination of ... & VAD. The Transplant Informatics..
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 ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
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 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 Medicare Appeals and Grievance Medical Director in Bethesda Maryland Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Job Information Kindred at Home Home Health Baylor Admissions RN in Towson Maryland The Clinical Assessment Advisor - Baylor directly completes and oversees development/ of the plan of treatment as approved ..
