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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..
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 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..
... 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 Description Summary 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 Information Humana Director, Medicaid Strategic Solutions in Washington District ... District Of Columbia Description Humana Medicaid is seeking exceptional candidates to ... exceptional candidates to join our Medicaid Product..
Description The Medical Director actively uses their medical background, ... to make determinations whether requested services, requested level of care, and/or ... work. Responsibilities Job Title: Medical Director Location: Work..
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..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Washington District ... Of Columbia Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
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..
Job Information Humana Director, Behavioral Health Network & Market Strategy (Medicaid) in Washington District Of Columbia ... District Of Columbia 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..
... 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..
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 Regional VP, Health Services (Mid-Atlantic Region) in Washington District ... Columbia Description The Regional VP, Health Services relies on medical background and ... on medical background and..
Job Information Humana Director, Behavioral Health Strategy in Washington District Of ... District Of Columbia Description The Director, Behavioral Health (DBH) will ensure that populations ... quality care for their..
... and Risk Adjustment National Medical Director in Washington District Of Columbia ... and Risk Adjustment National Medical Director leads key strategic and operational ... managed care industry including Medicare,..
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 &..
