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... charged with administering the TRICARE health plan in the East Region. ... processing operations and systems. The Director, Claims Oversight plays a vital ... relate to claims. Responsibilities The..
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... for all customers. Influences HBG's health services strategy by making decisions on ... care organization to include Medicare, Medicaid, TRICARE and/or Commercial products Deep ... TRICARE contracts and/or the..
Description The Director, Health Services utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The ... and/or benefit administration determinations. The Director, Health..
Description The Medical Director relies on medical background and ... on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The..
... for members of Medicare Advantage health plans and is committed to ... conditions. The practices also provide health education and value-added, well-being services at the centers and around .....
Description The Medical Director relies on medical background and ... on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Profile The..
... of excessive utilization of future health related services and to supplement Humana's Health Assessment Program. The summary of ... Risk Adjustment (MRA) and healthcare services. Responsibilities Job Title: Your..
Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills ... documentation and communication of medical services and/or benefit administration determinations. The ... and/or benefit administration..
Description The Director, Strategy Advancement provides data-based strategic ... making real improvements in member health outcomes. We're strategic and analytical, ... along the way. Responsibilities The Director, Retail Strategy &..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, ... hospital, and/or other provider behavioral health contracts for an organization that ... for an organization that provides..
Description The Associate Medical Director serves as a health-care professional and capable of handling ... of handling a variety of health-related problems. The Associate Medical Director requires a solid understanding..
... in Georgia providing direct care services, to clients in a home-based ... supervision, treatment, and comprehensive individualized services to help clients interact more ... and has been expanding its..
Description Healthcare isn't just about health anymore. It's about caring for ... as a whole. The Medical Director will be responsible for mentoring ... Chief Medical Officer, the Medical Director..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, ... hospital, and/or other provider behavioral health contracts for an organization that ... an organization that provides..
Description The Medical Director actively uses their medical background, ... to make determinations whether requested services, requested level of care, and/or ... work. Responsibilities Title: Commercial Medical Director Location: Work..
Description Humana's National Medicaid Quality team is seeking a ... be responsible for supporting individual Medicaid market quality teams and serving ... to the corporate level National Medicaid Quality team..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Atlanta Georgia ... Atlanta Georgia Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
