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Job Information Humana Care Team Medical Director in San Juan Puerto Rico Description The Care Team Medical Director is responsible for improving the quality of care and outcomes while managing costs ..
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 Medical Director - Texas in San Juan Puerto Rico Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested ..
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 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 ..
Job Information Humana Medicare Appeals and Grievance Medical Director in San Juan Puerto Rico Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in San Juan Puerto Rico Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work ..
Job Information Humana Medical Director - S. Florida in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..
... speak with contracted external physicians, physician groups, facilities, or community groups ... other healthcare providers, clinical group practice management. Utilization management experience in ... MCG® or InterQual Internal Medicine,..
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 - National Medicare Team in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director ..
Job Information Humana Medical Director - Florida Medicaid in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..
