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Description The Lead Medical Director relies on medical background and reviews health claims. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities The Lead ..
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... Humana is a Fortune 60 healthcare company with a history of ... 50 years as a proven leader and innovator in the health ... top place to work in..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
Description The Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization Behavioral ..
... with key hospital and group practice administrators and members. Communicate proactively ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting ... in the..
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u0026nbsp;u003c/strongu003eu003c/pu003enu003cpu003eThe Prior Authorization Nurse Analyst is a work from home position that will assist in reviewing medical documentation for prior authorization requests submitted.u003c/pu003enu003cpu003eu003cstrongu003eIn this role you will:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003ePerform review of ..
... physicians, physician groups, and integrated healthcare delivery systems throughout the country. ... delivery systems throughout the country. Healthcare isn't just about health anymore. ... of our members, and the..
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u003c/strongu003eu003c/pu003enu003cpu003eThe Clinical Supervisor (RN) will oversee a team of 20 to 30 remote Medical Review Nurseu0026nbsp; Analysts (NA) that complete Targeted Probe and Educate (TPE) work for our Medicare ..
Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
... a primary care medical group practice with centers open or opening ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach ... a tone of cooperation in..
... a primary care medical group practice with centers open or opening ... team consists of doctors, advanced practice professionals, Pharm D, care coach ... a tone of cooperation in..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
At GE Healthcare, our passionate people are creating the products, solutions and services our customers need to deliver the best patient care possible. Job Description Roles and Responsibilities Create vision and ..
Warby Parker is looking for a high-energy, innovative, and caring Full-Time Optometrist with a passion for delivering remarkable vision care in a collaborative environment. Our ideal candidate is a team player ..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
Description The Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
... Description The Clinical Strategy and Practice Lead builds strategies for development, ... enterprise. The Clinical Strategy and Practice Lead works on problems of ... trend projects and investigations. This..
... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the Healthcare Clinical Operations. After completion of ... Delivery Systems, health insurance, other..
Description The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly ..
