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Director, Contracting & Network Development','1199846','!*!Position Purpose: Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.Oversee provider contracting activities ..
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Description Responsibilities The Senior Clinical Insights Professional delivers clinical policy insight and information to both internal and external customers for Humana Government Business (HGB). The Senior Clinical Insights Professional will draft ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
... Responsibilities Title : Clinical Trend Medical Director Assignment: Enterprise Clinical Management, Clinical ... is seeking a Clinical Trend Medical Director. As a clinical trend leader ... that will positively..
Description The Lead Product Manager for Specialty products leads all phases of the product life cycle for Dental, Vision and Life products, from inception to introduction into the marketplace. Responsibilities Position ..
... brand for a primary care medical group practice with centers open ... of care. Follows level of medical care and quality for patients ... hospital and SNF coordination, durable..
Description The Director, Health Services utilizes clinical nursing ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... and/or benefit administration determinations. The Director, Health Services requires..
Description The Field Care Manager NP assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for ..
Description The Associate Director, Utilization Management Nursing utilizes clinical ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... benefit administration determinations. The Associate Director, Utilization Management..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities Job..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description The Vendor Quality Medical Director will manage clinical vendor quality ... Team. Responsibilities A full time Medical Director to manage clinical vendor quality ... to review quality audit findings,..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Commercial requirements ... daily work. Responsibilities Title:..
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 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 Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
Description The Transplant Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates transplant members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families ..
