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Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Title: Medical Director Location: Work..
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... drug manufacturers and providers. The Director, Pharmacy Clinical Formulary and Medical Strategies requires ... specialty to develop and/or implement clinical strategies to mitigate cost while ... medical drug strategies...
... Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving ... Management Company dedicated to improving clinical and quality outcomes by bridging ... conducted by licensed and trained..
... Work tasks assigned in the clinical documentation system Work assigned UM ... alternative levels of care using clinical knowledge and benefit plan design ... alternatives, if appropriate by analyzing..
Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a ... teams that report to this Associate director will assist in identifying 'NEW' ... industry. You will partner with Clinical,..
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..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description The Medical Director actively uses their medical background, ... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG, clinical reference materials,..
... closely with the market QI director on a frequent basis. Support ... expertise within the realm of Healthcare Quality operations and improvement methodology, ... measurement, and the improvement of..
... administration of care management. Provides non-clinical support to the assessment and ... established policies. This position provides non-clinical support supervising Care Manger Support ... support supervising Care Manger Support..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the ... and/or benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... to grow,..
... 41) market leader in integrated healthcare with a clearly defined purpose ... experience and vitality of the associate community. Through offerings anchored in ... we are seeking an experienced..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... a personalized, seamless and easy..
Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates ... business acumen. Responsibilities As the Director of Product Management for Clinical Pharmacy Products, you will be..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to ... acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Profile The Medical Director actively uses..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Dover Delaware ... in Dover Delaware Description The Associate Director, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The..
