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... drug manufacturers and providers. The Director, Pharmacy Clinical Formulary and Medical Strategies requires a broad understanding ... execute on the formulary and medical drug strategies. Responsibilities The Director, Pharmacy..
Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a few powerful teams dedicated to reducing waste and abuse in the health care industry and its impacts on Humana. These teams ..
Description The Director, Medical Coding extracts clinical information from ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g.,..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Profile..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Medicare and ... their daily work. Responsibilities..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... of variable factors Responsibilities..
Description The Medical Director relies on fundamentals of CMS ... and per diem requests. The Medical Director provides medical interpretation and determinations whether services ... some cases) contracts. Responsibilities The..
Description The Medical Director relies on fundamentals of CMS ... C Line of Business. The Medical Director provides medical interpretation and determinations whether services ... East Coast hours. Responsibilities The..
Description The Lead Behavioral Health Medical Director oversees the work of 2 ... oversees the work of 2 Medical Directors who conduct clinical case ... themselves. The Lead Behavioral Health..
Description The Medical Director relies on fundamentals of CMS ... C Line of Business. The Medical Director provides medical interpretation and determinations whether services ... Saturday and Sunday. Responsibilities The..
Job Information Humana Medical Director - S. Florida in Tampa ... in Tampa Florida Description The Medical Director relies on medical background and reviews health claims. ... and reviews health..
Job Information Humana Medical Director - National Medicare Team in ... in Tampa Florida Description The Medical Director relies on medical background and reviews preauthorization requests ... preauthorization requests for..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... Humana coverage policies and determinations, medical necessity criteria, clinical reference materials, ... conferences, and other reference sources. Medical..
... Stars and Risk Adjustment National Medical Director in Tampa Florida Description The ... nationally. This role relies on medical background, business acumen, and industry-standard ... Stars and Risk Adjustment..
Job Information Humana UM Medical Director - Conviva in Tampa Florida ... in Tampa Florida Description The Medical Director relies on medical background and reviews health claims. ... and reviews..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Medicare and ... daily work. Responsibilities Job..
Job Information Humana Medical Director - Texas in Tampa Florida ... in Tampa Florida Description The Medical Director relies on medical background and reviews health claims. ... and reviews health..
... Humana Medicare Appeals and Grievance Medical Director in Tampa Florida Description The ... in Tampa Florida Description The Medical Director relies on fundamentals of CMS ... C Line of..
Description The Medical Director relies on fundamentals of CMS ... C Line of Business. The Medical Director provides medical interpretation and determinations whether services ... a rotating basis Responsibilities The..
Description The Medical Director's primary responsibility is the review ... responsibility is the review of medical authorizations or claims to determine ... or claims to determine the medical necessity of..