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Description The Clinical Pharmacy Lead 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, and/or ..
... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
... of services provided by other healthcare professionals in compliance with review ... working with health insurance other healthcare providers, patient interaction, etc. Internal ... their home. We are a..
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 Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
Description Healthcare isn't just about health anymore. It is about caring for family, friends, finances, and personal life goals. It's about living life fully. At the Primary Care Organization, a division ..
... Albany New York Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
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 ..
... or community groups to support regional market priorities, which may include ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
... of services provided by other healthcare professionals in compliance with review ... or community groups to support regional market priorities, which may include ... whether services provided by other..
... Albany New York Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... across the enterprise to support..
Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..
... or community groups to support regional market care facilitation and priorities, ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Job Information Humana Medical Director - Texas in Albany New York Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..