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Job Information Humana Physician - CenterWell - Atlanta, GA ... a primary care medical group practice with centers open or opening ... all. Responsibilities The Primary Care Physician (PCP) works..
Job Information Humana Care Team Medical Director in Ridgeland Mississippi Description The Care Team Medical Director is responsible for improving the quality of care and outcomes while managing costs for a ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Ridgeland Mississippi Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to lead ..
... speak with contracted external physicians, physician groups, facilities, or community groups ... upon request of the attending physician Participates in HCO MD Inter-Rater ... Development forum (TAF) Collaborates with..
Description As a Physician Informaticist at Humana, you will ... functionally with other departments. The Physician Informaticist coordinates with other analytics, ... work meets clinical standards. The Physician informatacist works..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Ridgeland Mississippi Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
... organization is seeking a talented Physician executive that can contribute to ... / coding guidance to ensure physician and healthcare provider plans, education, ... corporate and regional strategies for..
