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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 guiding members/families toward ..
Job Information Humana National General Agency Relationship Manager in Springfield Missouri Description The National General Agency Relationship Manager will partner with Humana's wholesale distribution partners (General Agents) as well as the ..
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 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'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 ..
Job Information Humana Medical Director - National Medicare Team in Springfield Missouri Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
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 ..
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 ..
... add a detail oriented Property Manager to join their growing team. ... business! Qualifications of the Property Manager: High school or equivalent (Preferred) ... Essential Functions of the Property..
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 Medical Director - Medicare Pharmacy Appeals in Springfield Missouri Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Springfield Missouri Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
Job Information Humana Medicare Appeals and Grievance Medical Director in Springfield Missouri Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Job Information Humana UM Medical Director - Conviva in Springfield Missouri Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
