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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 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 ..
Job Information Humana UM Medical Director - Conviva in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..
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 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 ..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, ..
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 ..
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 - 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 ..
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 ..
