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... coordination, documentation and communication of medical services and/or benefit administration determinations. ... Management Nurse 2 reviews the medical documentation, completes telephonic reviews with ... appropriate criteria to make a..
... 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 ..
Job Information Humana Lead Product Manager - Healthcare API in Ridgeland Mississippi 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..
... PURPOSE AND SCOPE: Functions as part of the hemodialysis health care ... for Ultrafiltration (UF) goal; treatment time; Sodium (Na) modeling; and UF ... Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Fresenius..
... 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 Nationwide Associate Director, Utilization Management Nursing in Ridgeland ... Ridgeland Mississippi Description The Associate Director, Utilization Management Nursing utilizes clinical ... coordination, documentation and communication of medical..
... Humana Medicare Appeals and Grievance Medical Director in Ridgeland Mississippi Description The ... in Ridgeland Mississippi Description The Medical Director relies on fundamentals of CMS ... and reviewing appeals..
... 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 RN Telephonic Transplant Care Manager-WAH in Ridgeland Mississippi Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to ..
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 Oncology Market Director in Ridgeland Mississippi Description The ... Ridgeland Mississippi Description The Market Director, Oncology leverages targeted geographic analysis, ... Pharmacy for fulfillment. The Market Director,..
Job Information Humana Associate Director, Technology Solutions in Ridgeland Mississippi ... in the role of Associate Director, Technology Solutions to as a ... training, etc. Reports to a Director in..
Job Information Humana Care Team Medical Director in Ridgeland Mississippi Description The ... Mississippi Description The Care Team Medical Director is responsible for improving the ... unique opportunity to be..
... 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..
... 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..