Medical Director Part Time Jobs in Montpelier

... 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 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 Lead Product Manager - Healthcare API in Montpelier Vermont Description The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is directly ..

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..

... outcomes, and process efficiencies. Completes medical necessity and level of care ... Educates providers on utilization and medical management processes. Enters and maintains ... pertinent clinical information in various..

Job Information Humana Oncology Market Director in Montpelier Vermont Description The ... Montpelier Vermont Description The Market Director, Oncology leverages targeted geographic analysis, ... Pharmacy for fulfillment. The Market Director,..

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..

... 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 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..

... 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..

... 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. ... appropriate criteria to make a medical necessity determination. Complete telephonic, faxed, ... Case Management Discuss cases with..

Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Montpelier Vermont Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end ..

... Humana Medicare Appeals and Grievance Medical Director in Montpelier Vermont Description The ... in Montpelier Vermont Description The Medical Director relies on fundamentals of CMS ... and reviewing appeals..

... for performing clinical audits on medical record documentation for quality and ... support the submitted charges. Comprehensive medical records review will be conducted ... assigned by Supervisor, Manager and/or..

... 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..

Job Information Humana Nationwide Medicaid Behavioral Health Quality Lead in Montpelier Vermont Description The Behavioral Health Quality Lead will report directly to the National Medicaid Quality Director, and be responsible for ..

Job Information Humana Care Team Medical Director in Montpelier Vermont Description The ... Vermont Description The Care Team Medical Director is responsible for improving the ... unique opportunity to be..

Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Montpelier ... Montpelier Vermont Description The Associate Director, Utilization Management Nursing utilizes clinical ... coordination, documentation and communication of medical..

Job Information Humana Associate Director, Technology Solutions in Montpelier Vermont ... 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..