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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 ..
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 ..
Job Information Humana Medical Director - National Medicare Team in Montpelier Vermont Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
... Position Summary The HIM Coding Specialist will handle medical coding and ... outpatient procedures consistent with client contract and documentation in the medical ... problem list consistent with client..
Job Information Humana Medical Director - Florida Medicaid in Montpelier Vermont Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Description We are seeking a driven individual to support the Stars program to positively impact HEDIS performance through delivery of strategic initiatives and operational excellence. The role will support the preventive ..
Description The Pharmacy Development Specialist will be responsible for qualifying ... Responsibilities Summary The Business Development Specialist will be responsible for managing ... territory Coordinate sales campaigns with marketing for..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
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 Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Value-Based Programs Strategy Lead supports the creation of complex value-based programs. The Value-Based Programs Lead provides strategic advice and guidance to functional team(s) related to value-based vendor and specialty ..
Job Information Humana UM Medical Director - Conviva in Montpelier Vermont Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
... market contracting teams to influence specialist contract terms that align with Service ... in close coordination with PCP Contract Load, Capitation Rates, Payments, and ... Adjustments teams to ensure..
Job Information Humana Senior Contract Tools, Education, Processes Professional - ... Montpelier Vermont Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..
Job Information Humana Compliance Professional 2 - Medicaid in Montpelier Vermont Description Responsibilities Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's ..
