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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 Ridgeland Mississippi Description ... Mississippi Description The Care Team Medical Director is responsible for improving ... ground up. The Care Team Medical..
... and change lives with Fresenius Medical Care North America. Here, we ... team members. As the global leader in dialysis healthcare, we form ... When you join the Fresenius..
... Stars and Risk Adjustment National Medical Director in Ridgeland Mississippi Description ... clinical industry representative. As a leader, this role leads HQRI's Provider ... nationally. This role relies on..
Job Information Humana Strategy Advisor, Healthcare Strategy in Ridgeland Mississippi Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence ..
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 Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization ..
... for the PCO University. Monitor medical performance and provide guidance to ... years' experience in clinical practice Medical staff leadership experience for a ... practice, physician practice management organization,..
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..
... and documents in the patient medical record makes adjustments or modifications ... as indicated and notifies Team Leader Charge Nurse Supervisor or Physician ... approved algorithm(s) and documents appropriate..
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..
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 ..
... Functions as the hemodialysis team leader in the provision of chronic ... requested. Promote efficient use of medical supplies. Attend and participate in ... Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Fresenius..
Description The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of provider constituencies across all product lines, including Medicare, Medicaid and commercial. Primarily highly complex contracting arrangements. ..
Description The Medical Record Retrieval Specialist (Risk Adjustment ... within the region and scans medical records into a secure system. ... Humana's Coding staff. Responsibilities The Medical Record Retrieval Representative..
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..
Job Information Humana UM Medical Director - Conviva in Ridgeland ... in Ridgeland Mississippi Description The Medical Director relies on medical background and reviews health claims. ... and reviews health..
... and documents in the patient medical record, adjusts or modifies the ... as indicated and notifies Team Leader, Charge Nurse, Clinical Manager or ... approved algorithm(s), and documents appropriate..
... 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..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Ridgeland Mississippi Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to lead ..
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..
