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... work closely with the Quality Director, Behavioral Health Director, Quality Improvement Manager and those ... Qualifications Bachelor's degree in Business, Healthcare, or related field Certified Professional ... related field..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director actively uses..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Charleston ... West Virginia Description The Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director,..
... challenge and change.' The Associate Director, Technology Solutions devises an effective ... IT business initiatives. The Associate Director, Technology Solutions requires a solid ... across department(s). Responsibilities The Associate..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Description The Associate Director, Full Stack Engineering Performs software ... at the front-end. The Associate Director, Full Stack Engineering requires a ... for one of the leading healthcare organizations. Reporting..
Description The Medical Director actively uses their medical background, ... daily work. Responsibilities The Medical Director's work includes computer-based review of ... within their scope. The Medical Director may speak..
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. The Utilization Management Nurse 2 work assignments ..
... to the National Medicaid Quality Director. Responsibilities The Quality Improvement Program ... 3 years of experience managing Healthcare Quality programs OR 8 years ... their home. We are a..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... daily work. Responsibilities The Medical Director provides medical interpretation and decisions ... of services provided by other healthcare..
Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
... is looking for an Associate Director of Data Science to lead ... adverse health events. The Associate Director must be able to effectively ... problems being encountered. The Associate..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
Job Information Humana Director, Provider Contracting - Behavioral Health Medicaid in Charleston West Virginia Description The Director, Provider Contracting - Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other ..
... to the National Medicaid Quality Director, and be responsible for the ... Qualifications Bachelor's degree in Business, Healthcare, or related field. 5 years ... their home. We are a..
