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Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... of variable factors. Responsibilities The..
... This individual will drive effective communication within the Primary Care Organization/PCO ... Professional will support the PCO's communication needs and efforts to drive ... newsletters, intranet content and supporting..
Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM,..
... Stars and Risk Adjustment National Medical Director in Glen Allen Virginia ... and operations along with provider communication operations. HQRI is an organization ... nationally. This role relies on..
Description The Senior Pharmacy Clinical Advisor requires a broad understanding of pharmacy, managed care, PBM, market and regulatory insights to develop, and/or implement formulary strategies to mitigate cost trend and improve ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization ..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Medicare and ... their daily work. Responsibilities..
Description The Behavioral Health Medical Director makes determinations regarding prior ... Humana coverage policies and determinations, medical necessity criteria, clinical reference materials, ... conferences, and other reference sources. Medical Directors..
Description The Medical Director relies on fundamentals of ... C Line of Business. The Medical Director provides medical interpretation and determinations whether services ... Saturday and Sunday. Responsibilities The Medical..
Description The Medical Director's primary responsibility is the ... responsibility is the review of medical authorizations or claims to determine ... or claims to determine the medical necessity of a..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... East Coast hours. Responsibilities The..
Description The Behavioral Health Medical Director responsible for behavioral health ... and/or operations. The Behavioral Health Medical Director work assignments involve moderately ... Government Business's (HGB) Behavioral Health Medical Director..
... functions to implement formulary and medical strategies for the Medicaid line ... functions to implement formulary and medical strategies for the Medicaid line ... the implementation of formulary and..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... Government Business's (HGB) Behavioral Health..
Description The Medical Director relies on fundamentals of ... C Line of Business. The Medical Director provides medical interpretation and determinations whether services ... a rotating basis Responsibilities The Medical..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... of variable factors Responsibilities The..
Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..
Job Information Humana Medical Director - S. Florida in ... Glen Allen Virginia Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims...
