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Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
... specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Director, Market ... internally and externally. Develop a contract management oversight process that..
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 Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description The Market Development Professional 2 provides support to assigned health plan relative to Medicare/Medicaid product implementation, operations, and contract compliance. The Market Development Professional 2 work assignments are varied and ..
Description The Senior Project Manager, Medicaid Provider & Network Implementation ... and performance. The Senior Project Manager, Medicaid Network Implementation requires an ... Solutioning may also include some product development..
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 Responsibilities The Insurance Product Manager 2 will: Research each State's Medicaid rules, as it pertains to base benefits, expanded benefits, competitive analysis, etc. for intelligence gathering and strategy formulation Responsible ..
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 Director, Regional Sales - Partner Channel develops and maintains relationships with small and medium-sized accounts. The Director, Regional Sales - Partner Channel requires an in-depth understanding of how organization ..
Description The Senior Product Manager role is a part of ... a part of the Pharmacy Product & Growth organization and will ... in all phases of the product lifecycle..
Job Information Humana UM Medical Director - Conviva in Brentwood Tennessee Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Job Information Humana Director, Informatics in Brentwood Tennessee Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..
Job Information Humana Medical Director - Florida Medicaid in Brentwood Tennessee Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Medical Director - National Medicare Team in Brentwood Tennessee Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
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 ..
