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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 San Juan Puerto Rico Description The Care Team Medical Director is responsible for improving the quality of care and outcomes while managing costs ..
... as indicated by the prescribing physician. Communicates problems or concerns to ... to the Team Leader or physician. Identifies and communicates patient related ... issues to Team Leader or..
Job Information Humana Medical Director - Texas in San Juan Puerto Rico Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in San Juan Puerto Rico Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work ..
... 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..
... 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..
Job Information Humana Medical Director - Florida Medicaid in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..
Job Information Humana Medical Director - National Medicare Team in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director ..
