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... to the member's physician and medical director for appropriate interventions Works closely ... case managers, attendings, PCP and medical director, community agencies and other approved ... dotted line reporting..
Description The Senior Pharmacy Sales Executive leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions to Humana Pharmacy for fulfillment. The Senior Pharmacy Sales Executive ..
... to the member's physician and medical director for appropriate interventions* Works closely ... case managers, attendings, PCP and medical director, community agencies and other approved ... dotted line reporting..
... Care Solutions is seeking a Director of Risk Adjustment for the ... communication with team and Area Medical Leaders to ensure effectiveness of ... and consultative professional partnership with..
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 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 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 ..
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 medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Profile..
Description o Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical ..
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 ..
... 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 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 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 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 Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or ..
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 Associate Medical Director serves as a health-care professional ... of health-related problems. The Associate Medical Director requires a solid understanding of ... across department(s). Responsibilities The Associate Medical..
... 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 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:..
