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... Adjustment Integrity Unit (RAIU) Associate Director works collaboratively across the enterprise, ... seat at the legal and compliance table, for purposes of ensuring ... values. Responsibilities The RAIU Associate..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director actively uses..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Charleston ... West Virginia Description The Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director,..
Job Information Humana Associate Director, Provider Data Interoperability in Charleston ... Medicaid operational business. The Associate Director, Provider Data Interoperability plans, coordinates ... The Provider Data Interoperability Associate Director will..
... The Lead Behavioral Health Medical Director oversees the work of 2 ... clinical case reviews of the care received by members in an ... The Lead Behavioral Health Medical..
... at the given hotel. Ensure compliance with QA at the assigned ... of the hotel by monitoring compliance of the hotel’s action steps. ... Ensure Brand Standard Service training..
... and value, while also managing compliance with network requirements, including network ... Department of Health of Medicaid Managed Care Contract. The Lead will support ... This position reports to..
Compliance Director The candidate directs projects, initiatives, ... preparation, assessing audit preparedness. Leads compliance monitoring to identify process gaps, ... to identify process gaps, validate compliance levels, map processes, draft..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... within a context of regulatory compliance, and work is assisted by ... daily work. Responsibilities The Medical Director..
Job Information Humana Director, Informatics in Charleston West Virginia ... Charleston West Virginia Description The Director, Informatics coordinates with other analytics, ... insights from knowledge SMEs. The Director, Informatics requires..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Job Information Humana Director, Care Delivery and EMR/EHR Technology in ... Charleston West Virginia Description The Director, Technology Solutions devises an effective ... IT business initiatives specific to care delivery..
Description The Director, Product Management conceives of, develops, ... products for customer use. The Director, Product Management requires an in-depth ... function or segment. Responsibilities The Director, Product Management Leads..
... Medicaid Innovation) Multi-Payor and Accountable Care Initiatives. Responsibilities Immediately leverages a ... of big-picture vision, deep value-based care experience and a 'seeking to ... such as clinical, legal, and..
... ensure the highest level of care for our customers. This team ... our associates. Responsibilities The Associate Director, Product Management leads all phases ... Product leadership team, the Associate..
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 ..
... promote cost-effective delivery of health care services. Share your talents and ... medical necessity and level of care reviews for requested services using ... the Chief Medical Officer (CMO)/Medical..
Description The Director, Clinical Pharmacy Drug Evaluation and ... manufacturers and providers. Responsibilities The Director, Clinical Pharmacy Drug Evaluation and ... a broad understanding of pharmacy, managed care, and specialty..
Description The Medical Director actively uses their medical background, ... requested services, requested level of care, and/or requested site of service ... within a context of regulatory compliance, and work..
... across members, providers, agents, clinical, care management, pharmacy, and other units. ... new benefits launch, provider find care, provider management self-service, and provider ... management. Innovate on clinical and..
Job Information Marriott Director-Engineering in Charleston West Virginia Additional ... Charleston West Virginia Additional Information Director, Electric Vehicle (EV) Charging Program ... wherever we do business. The Director, Electric Vehicle..
