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Adjunct Online Instructor - Advanced Healthcare Law and Ethics The candidate will report to an Academic Dean. Will be primarily responsible for teaching courses in a variety of modalities while promoting ..
Description The Quality Compliance Professional 2 completes annual quality ... reviews and research. The Quality Compliance Professional 2 work assignments are ... of action. Responsibilities The Quality Compliance Professional 2..
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 ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Fargo North Dakota Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that ..
Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
... resolving professional issues. • Ensures compliance with standards of care and ... ordered pharmacologic agents. Assesses patient's compliance, barriers to compliance and develops a nursing plan ... accordance with..
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 Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Fargo North Dakota Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to ..
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 ..
Description The Senior Market Consultation/Partnership Professional promotes and improves the quality and measurement of care delivery programs with a market(s). The Senior Market Consultation/Partnership Professional work assignments involve moderately complex to ..
