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Description The Lead Medical Director relies on medical background and reviews health claims. ... reviews health claims. The Lead Medical Director requires a solid understanding ... across department(s). Responsibilities The..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Commercial requirements ... daily work. Responsibilities Title:..
Job Information Humana Care Team Medical Director in Aberdeen South Dakota ... Dakota Description The Care Team Medical Director is responsible for improving ... ground up. The Care Team Medical..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Aberdeen South Dakota Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to ..
... initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ... day of employment. Benefits include: Medical Benefits Dental Benefits Vision Benefits ... physician groups, ancillary providers and/or..
... health ministry. Has MHA/MBA/MS in hospital administration, healthcare administration or equivalent ... Must be able to comprehend hospital policies, procedures and guidelines. Must ... coordination with the Board, the..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Medicare and ... their daily work. Responsibilities..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of ..
... Stars and Risk Adjustment National Medical Director in Aberdeen South Dakota ... clinical industry representative. As a leader, this role leads HQRI's Provider ... nationally. This role relies on..
Description The Medical Director's primary responsibility is the ... responsibility is the review of medical authorizations or claims to determine ... or claims to determine the medical necessity of a..
Description The Medical Director relies on fundamentals of ... C Line of Business. The Medical Director provides medical interpretation and determinations whether services ... a rotating basis Responsibilities The Medical..
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 Strategy Advisor, Healthcare Strategy in Aberdeen South Dakota Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction to identify and address business issues and opportunities. Provides business ..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... factors. Responsibilities Job Profile The..
Job Information Humana UM Medical Director - Conviva in Aberdeen ... Aberdeen South Dakota Description The Medical Director relies on medical background and reviews health claims. ... and reviews health..
Specialty: RN-Medical Surgical TravelJob Description Registered nurses ... this specialty practice primarily on hospital units and care for adult ... with a wide variety of medical problems and diseases or..
Description The Lead Behavioral Health Medical Director oversees the work of ... oversees the work of 2 Medical Directors who conduct clinical case ... themselves. The Lead Behavioral Health Medical..
Description The Behavioral Health Medical Director makes determinations regarding prior ... Humana coverage policies and determinations, medical necessity criteria, clinical reference materials, ... conferences, and other reference sources. Medical Directors..
