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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 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 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 &..
... 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 .....
Job Information Humana Medicaid Associate Director, Compliance Nursing in Indianapolis Indiana ... Indianapolis Indiana Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
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..
... as part of the hemodialysis health care team in providing safe ... forth in the FMS Clinical Services Clinical Training Manual(s), FMS policies ... practices. PATIENT RELATED: Education:Assist other..
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:..
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 Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support ... documentation, and communication of medical services and/or benefit administration determinations. The ... determinations...
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 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 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..
... organizational efforts on improving behavioral health (BH)/Substance Use Disorder (SUD) clinical ... Humana Healthy Horizons in Kentucky Medicaid Plan. They will plan, perform, ... sustainable, repeatable, and quantifiable behavioral..
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..
... organizational efforts on improving Kentucky Medicaid clinical quality performance measures to ... Humana Healthy Horizons in Kentucky Medicaid Plan. Plans, performs, and implements ... closely with the Quality Improvement..
