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... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... Behavioral Health Professional 2 completes medical record reviews from medical records sent from Behavioral Health ... appropriate..
Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of ..
Description The Director of Health Services for National ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... and/or benefit administration determinations. The Director, Health Services requires..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities Job..
Description The Associate Director, Utilization Management Nursing utilizes clinical ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... benefit administration determinations. The Associate Director, Utilization Management..
... part of the hemodialysis health care team in providing safe and effective ... of all appropriate direct patient care personnel as well as the ... as preceptor in direct..
Description The Associate Director, Quality Assurance for Humana/Your Home ... Home Wellness Assessments. The Associate Director, Quality Assurance requires a solid ... requires a solid understanding of medical documentation and..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., ... new brand for a primary care medical group practice with centers open ... and Texas. CenterWell Senior Primary Care..
... Indiana Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., ... new brand for a primary care medical group practice with centers open ... and Texas. CenterWell Senior..
... monitors drug development pipeline, and medical literature, while providing clinical support ... Utilizes broad understanding of managed care and PBM knowledge to develop, ... wholly owned hospice and palliative..
Description The Senior Quality Improvement Professional will focus organizational efforts on improving behavioral health (BH)/Substance Use Disorder (SUD) clinical quality performance measures to achieve optimal performance and quality for the Humana ..
... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... appropriate criteria to make a medical necessity determination. Complete telephonic reviews ... Assess discharge plans Coordinated with..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... of variable factors. Responsibilities..
Description The Medical Director actively uses their medical background, experience, and judgement to ... requested services, requested level of care, and/or requested site of service ... conferences, and other reference..
Description Humana's Enterprise Clinical Management team needs your clinical, business and ... The Clinical Analytics and Trend team uses advanced scientific techniques, data ... and improve the value of care..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Profile..
... for performing clinical audits on medical record documentation for quality and ... as outlined in the Autism Care Demonstration (ACD) policy, TRICARE Operations ... support the submitted charges. Comprehensive..
