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Description Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. As ... a whole. As a senior-focused healthcare provider, and subsidiary of..
Description o Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical ..
Description The Stars Improvement Coordinator develops, implements, and manages ... Program. Directs all Stars quality improvement programs and initiatives. The Stars ... programs and initiatives. The Stars Improvement Coordinator performs..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Posted: 02-Mar-22 Location: San Antonio, Texas Salary: Open Categories: General Nursing Internal Number: 25485 Description CHRISTUS Santa Rosa Health System is about people. People we meet and care for; people whose ..
Description The Staff Clinical Pharmacist is an integral part of the Clinical Drug Policy Management team which ensures synchronization of formulary utilization management policies across multiple systems. Humana is seeking a ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in San Antonio Texas Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is ..
Job Information Humana Stars Improvement Coordinator - Remote TX in ... Antonio Texas Description The Stars Improvement Coordinator Quality Initiatives assists in ... Medicare Stars Program. The Stars Improvement Coordinator..
Job Code 2172024 For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of ..
Job ID 21000KMPAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and policy requirements. Assists ..
Job Information Humana Medicare Appeals and Grievance Medical Director in San Antonio Texas Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
Description Provides executive leadership to Humana. Responsibilities Humana's Primary Care Organization is one of the largest and fastest growing value-based, senior primary care groups in the country, providing care to over ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
... Certified Diabetes Care and Education Specialist-Remote-US in San Antonio Texas Description ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
Job Information Humana FP&A Lead, Medicaid Market in San Antonio Texas Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
