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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..
... 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..
... Job Description Summary The RVP Health Services relies on medical background to ... state of Florida. The RVP Health Services requires an in-depth understanding of ... segments and/or enterprise-wide...
... 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, 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 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 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 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..
... 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..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Tampa Florida ... Tampa Florida 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..
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 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 Associate Director Utilization Management in Tampa Florida ... are looking for an Associate Director, Utilization Management to utilize clinical ... documentation and communication of medical services and/or..
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, 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 ..
