Managed Care Compliance Director Jobs in Pennsylvania

Description Humana Military is the Managed Care Support Contractor (MCSC) for the ... processing operations and systems. The Director, Claims Oversight plays a vital ... individual in this role will..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania Description ... Pittsburgh Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management activities ... waste, and abuse. The..

Job Information Humana Director, Contract Tools, Education, Processes (remote ... in Pittsburgh Pennsylvania Description The Director, Contract Tools, Education, Processes manages ... best in class knowledge. The Director, Contract Tools,..

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..

Description The Director, Pharmacy Clinical Formulary and Medical ... the formulary strategies. Responsibilities The Director, Pharmacy Clinical Formulary and Medical ... a broad understanding of pharmacy, managed care, PBM, market..

... and Risk Adjustment National Medical Director in Pittsburgh Pennsylvania Description The ... and Risk Adjustment National Medical Director leads key strategic and operational ... clinical experience Knowledge of the..

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 provides medical..

... Job Description Summary The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Description The Medical..

Job Information Humana Director, Informatics in Pittsburgh Pennsylvania Description ... in Pittsburgh Pennsylvania Description The Director, Informatics coordinates with other analytics, ... insights from knowledge SMEs. The Director, Informatics requires..

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..

Description The Medical Director's primary responsibility is the review ... given service or level of care. The Medical Director's work assignments involve moderately complex ... of health. Responsibilities The Medical..

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..

Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Profile The Medical Director actively uses..

Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Profile The Medical Director actively uses..

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral ... operations. The Behavioral Health Medical Director work assignments involve moderately complex ... Business's..

Description The Care Manager, Telephonic Nurse 2 , ... with resources appropriate for the care and wellbeing of members. Responsibilities ... Eastern Time Zone The Transplant Care Manager, Telephonic Nurse..

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 provides medical..

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..

We're BAYADA Home Health Care -a leading home health care company-and we believe that our ... their families deserve home health care delivered with compassion, excellence, and ... in providing..

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..

Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director will provide..

... medical group provides home-based medical care to chronically ill patients, many ... frail and elderly, we deliver care primarily in the comfort of ... the space, respect, compassion and..

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..