Clinical Practice Specialist Jobs in North Dakota

Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..

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, ..

Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Fargo ... team that helps translate the clinical into financial to ensure Humana ... and providers. The Director, Pharmacy Clinical..

... providers. Responsibilities The Director, HPS Clinical Programs requires a broad understanding ... managed care, and patient centered clinical programs with a focus on ... design to develop patient centered..

... Health Medical Director will provide clinical oversight to Behavioral Health (BH) ... Behavioral Health (BH) administrative and clinical programs for TRICARE beneficiaries. They ... Essential Functions and Responsibilities Lead..

... The Medical Director relies on clinical background and reviews Medicare drug ... Pharmacy Policies and Procedures, and clinical literature as appropriate. Medical Directors ... degree 5 years of direct..

... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations,..

Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies ... HPS executive leaders, Trade Relations, Clinical, Analytics, Actuaries, and Operation functions ... strategies. Responsibilities The Director, Pharmacy Clinical Formulary..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Fargo North Dakota Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..

... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations,..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work ... North Dakota Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug ... and medical literature, while providing clinical support for..

... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations,..

... Health Medical Director will provide clinical oversight to Behavioral Health (BH) ... Behavioral Health (BH) administrative and clinical programs for TRICARE beneficiaries. They ... Essential Functions and Responsibilities Lead..

... license and the ability to practice in all the states that ... minimum of 3 years of clinical nursing experience. Demonstrated clinical knowledge and expertise as evidenced ... solving..

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 ..

... team that helps translate the clinical into financial to ensure Humana ... leadership on key metrics. Support clinical research integration activities with internal ... and cross-functional teams Five years..

Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Fargo North Dakota Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..

... 2 Medical Directors who conduct clinical case reviews of the care ... Medical Director for the Humana Clinical Operations Behavioral Division is looking ... physical integration, care modeling, best..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Fargo North Dakota Description Humana is looking for an experienced Healthcare Investigator to join its ..

... prepare the Behavioral Health( BH) Clinical Team with the tools necessary ... authorizations, and referrals not requiring clinical review Appropriately route cases needing ... review Appropriately route cases needing..

... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations,..

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 ..

Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Fargo North ... Dakota Description The Senior Pharmacy Clinical Advisor will be part of ... to the development of..