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Description The Care Manager, Telephonic Behavioral Health 2 , ... in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by .....
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... of Payment Integrity, will create and implement process improvement plans focused ... plans focused on the beneficiary and provider experience, as well as ... Associate Director will lead design..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is ... is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of ... Member Plan..
... prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests ... issues regarding technical approach for project components, and work is..
... Delaware Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient business solutions for quality assurance and risk mitigation in implementing Humana's ... Provider Data..
... uses their medical background, experience, and judgement to make determinations whether ... requested services, requested level of care, and/or requested site of service should ... within a context of..
... Director relies on medical background and reviews health claims. The Medical ... Medical Director provides medical interpretation and decisions about the appropriateness of ... by other healthcare professionals in..
... Director relies on medical background and reviews health claims. The Medical ... to Behavioral Health (BH) administrative and clinical programs for TRICARE beneficiaries. ... to integrate the day-to-day administration..
Description The Project Manager manages all aspects of a ... manages all aspects of a project, from start to finish, so ... it is completed on time and within budget...
... Director relies on medical background and reviews health claims. The Medical ... uses their medical background, experience, and judgement to make determinations whether ... requested services, requested level of..
Job Information Humana Director, Care Delivery and EMR/EHR Technology in Dover Delaware ... an effective strategy for executing and delivering on IT business initiatives ... IT business initiatives specific to..
Job ID 21000LDMAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, ... FMCNA’s mission, vision, core values and customer service philosophy. Adheres to ... philosophy. Adheres to the FMCNA Compliance..
... Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical ... to Behavioral Health (BH) administrative and clinical programs for TRICARE beneficiaries. ... to integrate the..
Job Information Humana Director, Care Delivery and EMR/EHR Technology in Wilmington Delaware ... an effective strategy for executing and delivering on IT business initiatives ... IT business initiatives specific to..
... makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that ... that members receive clinically appropriate and medically necessary services. All work .....
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Dover ... Delaware Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible ... is responsible for the administration..
... given service or level of care. The Medical Director's work assignments ... that rely on clinical experience and knowledge of both medicine and social determinants of health. Responsibilities .....
... Medical Director - National Medicare Team in Dover Delaware Description The ... Director relies on medical background and reviews preauthorization requests for services. ... Medical Director provides medical interpretation..
