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Description The Medical Director relies on medical background and ... on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Title:..
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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..
... 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, 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..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Birmingham Alabama ... Birmingham Alabama Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
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..
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..
Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
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..
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 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..
... 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 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..
