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Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... you succeed, we succeed! The Manager, Care Management oversees..
Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..
... Information Humana Medicaid Associate Director, Compliance Nursing in Washington District Of ... Columbia Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 ..
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 ..
... philosophy. Adheres to the FMS Compliance Program, including following all regulatory and FMS policy requirements. PRINCIPAL ... programs which require the case manager to meet the patient, the .....
Description In collaboration with the Director of Ambulatory Services and other members of the management team, provide administrative and business leadership for the Children's National ambulatory facility(s). Qualifications Minimum Education Bachelor's ..
Description Job Description Summary 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 ..
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 ..
Ambulatory Svcs OPS & PI Manager (EVERGREEN) ','230001JY','!*!The Operations and Process ... ','230001JY','!*!The Operations and Process Improvement Manager for Ambulatory Services will facilitate, ... Transformation, the Operations and PI Manager..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Washington District Of Columbia Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Washington District Of Columbia Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for ..
Job Information Humana UM Medical Director - Conviva in Washington District Of Columbia Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..
Description The Manager, Compliance Nursing reviews utilization management activities ... fraud, waste, and abuse. The Manager, Compliance Nursing works within specific guidelines ... schedules and goals. Responsibilities The Manager, Compliance..
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 ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Washington District Of Columbia Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Of Columbia Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Washington District Of Columbia Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive ..
