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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 ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Job Information Humana Care Team Medical Director in Honolulu Hawaii Description The Care Team Medical Director is responsible for improving the quality of care and outcomes while managing costs for a ..
PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision ..
Job Information Humana Medical Director - National Medicare Team in Honolulu Hawaii Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
... as directed by supervisor or physician. This individual will assess patient ... patient related issues to the physician as needed. Reports adverse patient ... Manager/Home Therapy Program Manager, and..
... experience and knowledge of both medicine and social determinants of health. ... speak with contracted external physicians, physician groups, facilities, or community groups ... as MCG® or InterQual Internal..
Job Description Kapiolani Medical Center for Women & Children is well recognized as Hawaiis leader in the care of women, infants and children. With 207 beds and 66 bassinettes, the nonprofit ..
Job Information Humana Medical Director - Florida Medicaid in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Honolulu Hawaii Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
... speak with contracted external physicians, physician groups, facilities, or community groups ... as MCG® or InterQual Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists Advanced degree such..
Job Information Humana Medical Director - Texas in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to ..
