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Description The SC Medicaid CMO, RVP Health Services (CMO)relies on medical background to create and oversee clinical strategy for the region. The CMO requires an in-depth understanding of how organization capabilities ..
Description The Manager, Utilization Management Nursing utilizes clinical ... documentation and communication of medical services and/or benefit administration determinations. The ... and/or benefit administration determinations. The Manager, Utilization Management Nursing..
... to make determinations whether requested services, requested level of care, and/or ... and appeals processes, and outpatient services and equipment, within their scope. ... medical interpretation and determinations whether..
Job Information Humana Medical Director - S. Florida in Lancaster South Carolina Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
... that medically necessary and appropriate services are in place and are ... to make determinations whether requested services, requested level of care, and/or ... and appeals processes, and outpatient..
... to make determinations whether requested services, requested level of care, and/or ... medical interpretation and determinations whether services provided by other healthcare professionals ... and the Regional VP Health..
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 ..
... and reviews preauthorization requests for services. The Medical Director work assignments ... medical interpretation and determinations whether services provided by other healthcare professionals ... medical interpretation and determinations whether..
Job Information Humana Medical Director - Texas in Lancaster South Carolina Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
... to make determinations whether requested services, requested level of care, and/or ... and appeals processes, and outpatient services and equipment, within their scope. ... and/or home health or post-acute..
Job Information Humana Manager, Utilization Management RN - Remote ... Lancaster South Carolina Description The Manager, Utilization Management Nursing utilizes clinical ... documentation and communication of medical services and/or benefit..
Job Information Humana Manager, Utilization Management Nursing - Medicare ... Lancaster South Carolina Description The Manager, Utilization Management Nursing utilizes clinical ... documentation and communication of medical services and/or benefit..
... decisions about the appropriateness of services provided by other healthcare professionals ... medical interpretation and determinations whether services provided by other healthcare professionals ... and the Regional VP Health..