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... and determinations, clinical reference materials, internal teaching conferences, and other sources ... work, communication of decisions to internal associates, participation in care management ... speak with contracted external physicians,..
Job Information Humana Medicare Appeals and Grievance Medical Director in Lancaster South Carolina Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Lancaster South Carolina Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..
... and determinations, clinical reference materials, internal teaching conferences, and other reference ... work, communication of decisions to internal associates, and possible participation in ... speak with contracted external physicians,..
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 ..
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 ..
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 ..
... determinations, MCG, clinical reference materials, internal teaching conferences, and other reference ... work, communication of decisions to internal associates, and possible participation in ... speak with contracted external physicians,..
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..
... experience and knowledge of both medicine and social determinants of health. ... and determinations, clinical reference materials, internal teaching conferences, and other reference ... work, communication of decisions to..
... care providers in quality-based, senior-focused medicine for existing and new centers ... Board Certified MD/DO in Family Medicine, Internal Medicine or Geriatric Medicine Maintain license in state of .....
... 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..
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, ..
... and determinations, clinical reference materials, internal teaching conferences, and other reference ... work, communication of decisions to internal associates, and possible participation in ... such as MCG® or InterQual..
... and determinations, clinical reference materials, internal teaching conferences, and other sources ... work, communication of decisions to internal associates, and possible participation in ... speak with contracted external physicians,..
