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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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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..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Chicago Illinois ... Chicago Illinois Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
... and Risk Adjustment National Medical Director in Chicago Illinois Description The ... and Risk Adjustment National Medical Director leads key strategic and operational ... managed care industry including Medicare,..
... Insurance Trust Fund Agreement. The Director, Clinical Risk Management reports to ... Management and staff regarding mental health and consent issues. Required Job ... federal Centers for Medicare and..
... a company focused on the health and well-being of the people ... use for Humana's 8M Medicare, Medicaid and Pharmacy members Simplify and ... personalized medication list, and manage..
Job Information Humana Director, Behavioral Health Strategy in Chicago Illinois Description ... in Chicago Illinois Description The Director, Behavioral Health (DBH) will ensure that populations ... quality care for their..
... Indiana is seeking a Provider Services Advisor (Market Development Advisor) who ... tactical support of the Provider Services team. They will advise the ... team. They will advise the..
Job Information Humana Director, Behavioral Health Network & Market Strategy (Medicaid) in Chicago Illinois Description The ... in Chicago Illinois Description The Director, Behavioral Health (BH) Network and Market Strategy..
Description The Medical Director actively uses their medical background, ... to make determinations whether requested services, requested level of care, and/or ... daily work. Responsibilities The Medical Director's work includes..
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 &..
... Horizons is seeking a Medical Director to help develop and execute ... the Vice President and CMO Medicaid. Responsibilities Medical Directors actively use ... to make determinations on requested..
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 Director of Public Policy in Chicago ... in Chicago Illinois Description The Director of Public Policy role resides ... not limited to, Medicare Advantage, health IT, interoperability,..
Description The Director, Pharmacy Clinical Formulary and Medical ... lines of business (Medicare, Commercial, Medicaid). This position will work and ... the formulary strategies. Responsibilities The Director, Pharmacy Clinical Formulary..
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...
... 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..
Job Information Humana Director, Medicaid Strategic Solutions in Chicago Illinois ... in Chicago Illinois Description Humana Medicaid is seeking exceptional candidates to ... exceptional candidates to join our Medicaid Product..
Description As Humana's Medicaid membership continues to grow, the ... continues to grow, the National Medicaid Clinical Operations team is expanding ... team is expanding our shared services organization to..
