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... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... appropriate criteria to make a medical necessity determination. Complete telephonic, faxed, ... Case Management Discuss cases with..
Description The Chief Medical Officer, Group Medicare relies on the medical background to create and oversee clinical strategy for the Group Medicare business. The CMO Group Medicare, requires and in-depth understanding ..
Description The Director, Pharmacy Clinical Pipeline oversees the ... Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking ... and finance teams. Responsibilities The Director, Pharmacy Pipeline requires..
Job Information Humana Associate Director, Technology Solutions in Billings Montana ... in the role of Associate Director, Technology Solutions to as a ... training, etc. Reports to a Director in..
Description The Medical Director relies on fundamentals of CMS ... and reviewing appeals for Medicare Part C Line of Business. The ... C Line of Business. The Medical Director provides..
... Humana Medicare Appeals and Grievance Medical Director in Billings Montana Description The ... in Billings Montana Description The Medical Director relies on fundamentals of CMS ... and reviewing appeals..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Billings ... Billings Montana Description The Associate Director, Utilization Management Nursing utilizes clinical ... coordination, documentation and communication of medical..
... Product Manager role is a part of the Pharmacy Product & ... across Medicare, Medicaid and Commercial medical and pharmacy insurance products. Although ... include nurses, pharmacists and regional..
... brand for a primary care medical group practice with centers open ... fewer patients and spend more time with those they do. Evaluates ... of care. Follows level of..
Job Information Humana Care Team Medical Director in Billings Montana Description The ... Montana Description The Care Team Medical Director is responsible for improving the ... unique opportunity to be..
Job Information Humana Lead Product Manager - Healthcare API in Billings Montana Description The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is directly ..
... the BH Supervisor/ Manager or Director Required Qualifications Experience working with ... investigative skills Excellent organizational and time management skills Strong attention to ... with clear direction and as..
... brand for a primary care medical group practice with centers open ... fewer patients and spend more time with those they do. Responsibilities: ... of care. Follows level of..
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..
Job Information Humana Oncology Market Director in Billings Montana Description The ... Billings Montana Description The Market Director, Oncology leverages targeted geographic analysis, ... Pharmacy for fulfillment. The Market Director,..
... Healthy Horizons is seeking a Medical Director to help develop and execute ... develop initiatives to address women's medical and behavioral needs for adolescents, ... role requires strong collaboration..
... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... Behavioral Health Professional 2 completes medical record reviews from medical records sent from Behavioral Health ... appropriate..