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Description The Part D Senior Savings Model or Insulin Savings Program, is a new Medicare health plan program offered through the Center for Medicare and Medicaid Innovation (CMMI). It provides insulin ..
Description The Supervisor, Provider Engagement develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working ..
... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of moderately complex to complex..
Description Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that all ..
Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Riverton Wyoming Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Riverton Wyoming Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
Description The Value-Based Programs Strategy Lead supports the creation of complex value-based programs. The Value-Based Programs Lead provides strategic advice and guidance to functional team(s) related to value-based vendor and specialty ..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
