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... the coordination, documentation, and communication of medical services and/or benefit administration determinations. The ... require interpretation and independent determination of the appropriate courses of action. Responsibilities The Utilization Management..
... analyze and measure the effectiveness of existing initiatives, and develop sustainable, ... work closely with the Quality Director, Behavioral Health Director, Quality Improvement Manager and those ... those targeting..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... complex issues where the analysis of situations or..
... daily, weekly, or monthly records of clients’. Submits clinical paperwork to ... coordinates and contributes to department in-services. Notify physical therapist or Executive ... Notify physical therapist or Executive..
Job Information Humana Director of Public Policy in Charleston West ... Charleston West Virginia Description The Director of Public Policy role resides in ... development for a broad range of..
... is the nation's leading provider of healthcare services from short-term to long-term care ... care and a wide variety of living options and professional clinical ... living options and..
Genesis HealthCare is one of the leading providers of healthcare services from short-term to long-term care ... care and a wide variety of living options and professional clinical ... living..
... the end to end ownership of Humana Healthy Horizon's National Quality ... and the development and maintenance of QI frameworks and toolkits to ... Quality associates throughout the line..
... leader, you will be part of a close-knit, collaborative team responsible ... creates and supports a culture of continuous learning for our managers. ... an Area Team Lead or..
... to the National Medicaid Quality Director, and be responsible for the ... the development, maintenance, and execution of Humana Healthy Horizon's National Improvement ... Quality, within the Medicaid line..
... to solve the technology challenges of tomorrow. You'll collaborate with a ... challenge and change.' The Associate Director, Technology Solutions devises an effective ... IT business initiatives. The Associate..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... reviews for inpatient and outpatient services to ensure that members receive ... clinically appropriate and medically necessary services...
... The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct ... who conduct clinical case reviews of the care received by members ... may..
... an experienced and dynamic Associate Director of Accreditation to manage a team ... Accreditation to manage a team of subject matter experts on NCQA ... have a proven track..
... and oversee the daily operations of the dialysis clinic. You will ... will collaborate with the Medical Director and the Charge Nurse regarding ... Charge Nurse regarding the provision..
Description The Medical Director actively uses their medical background, ... to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All .....
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Charleston ... West Virginia Description The Associate Director, Utilization Management Nursing utilizes clinical ... the coordination, documentation and communication of..
... guidelines and policies, and approves services or forward requests to the ... assist with questions and mentoring of clinical staff Reviews and resolves ... other CarePlus departments Leads implementation..
Genesis is one of the nations' leading provider of healthcare services from short-term to long-term care ... care and a wide variety of living options and professional clinical ... living..
Job Information Humana Director, Behavioral Health Strategy in Charleston ... Charleston West Virginia Description The Director, Behavioral Health (DBH) will ensure ... their behavioral health needs. The Director, Behavioral Health..
