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... part of building an innovative clinical strategy and shaping the necessary ... part of building an innovative clinical strategy and shaping the necessary ... this role you will: Provide..
... 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..
... 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..
... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... 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,..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in San Juan Puerto Rico Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading ..
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 Fraud and Waste Investigator - Work At Home (Anywhere in the US) in San Juan Puerto Rico Description Humana is looking for an experienced Healthcare Investigator to join ..
... 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..
... assignments. Required 5 years of clinical experience A current and unrestricted ... with 5 years of established clinical experience Knowledge of the managed ... interaction, etc. Internal Medicine, Family..
... actions. Recommend disciplinary action to Clinical Manager and initiate as appropriate. ... in the absence on the Clinical Manager ensuring compliance with applicable ... efficient, and effective matter. With..
... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... degree 5 years of direct clinical patient care experience post residency ... health insurance, other healthcare providers,..
... 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..
... 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..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in San Juan Puerto Rico Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews ..
