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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 ..
Job Information Humana Regional Community Engagement Professional 2- OHIO ... Health Equity and Community Engagement Regional Coordinator (Community Management Professional 2) ... action. Requires collaboration with other regional coordinators, and..
... 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..
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 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,..
... in Cincinnati Ohio Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
... in Cincinnati Ohio Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... across the enterprise to support..
... SCOPE: Works with the Facility Manager, facility staff and physician to ... in conjunction with the Facility Manager.Assists Facility Manager with staff performance evaluations.Participates in ... management guidelines.Acts as..
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 CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
PURPOSE AND SCOPE:Manages patient care in home therapies programs while maintaining cost-effective clinical operations. Provides direction and guidance to the interdisciplinary team providing care to the Home Therapies patients to ensure ..
Job Information Humana Regional Community Management Professional in Cincinnati ... Health Equity and Community Engagement Regional Coordinator (Community Management Professional 2) ... action. Requires collaboration with other regional coordinators, and..
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 ..
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). ..
