Associate Director Healthcare Clinical Jobs in Dover

... drug manufacturers and providers. The Director, Pharmacy Clinical Formulary and Medical Strategies requires ... specialty to develop and/or implement clinical strategies to mitigate cost while ... medical drug strategies...

... Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving ... Management Company dedicated to improving clinical and quality outcomes by bridging ... conducted by licensed and trained..

Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a ... teams that report to this Associate director will assist in identifying 'NEW' ... industry. You will partner with Clinical,..

Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Dover ... in Dover Delaware Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the .....

Description The Medical Director actively uses their medical background, ... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG, clinical reference materials,..

Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..

... Analytics is looking for an Associate Director of Data Science to lead ... future adverse health events. The Associate Director must be able to effectively ... business problems being..

Description The Medical Director relies on fundamentals of CMS ... per diem requests. The Medical Director provides medical interpretation and determinations ... whether services provided by other healthcare professionals are..

Job Information Humana Associate VP, Clinical Pharmacy (Remote) in Dover Delaware ... in Dover Delaware Description The Associate VP, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while..

Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical Director provides medical interpretation and determinations ... whether services provided by other healthcare professionals are..

Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the ... and/or benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... to grow,..

Job Information Humana Medical Director - S. Florida in Dover ... Dover Delaware Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Dover Delaware ... in Dover Delaware Description The Associate Director, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The..

Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to ... acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team..

Job Information Humana Associate Director, Technology Solutions in Dover Delaware ... team in the role of Associate Director, Technology Solutions to as a ... training, etc. Reports to a Director..

Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, ... and medical literature, while providing clinical support for internal stakeholders. Utilizes ... and improve health outcomes. The Associate Director,..

Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Dover ... team that helps translate the clinical into financial to ensure Humana ... external vendors and providers. The Director,..

Description The Director, Pharmacy Clinical Pipeline oversees the medical and ... leaders across the Humana enterprise, clinical subject matter experts, analytics, actuaries ... and finance teams. Responsibilities The Director, Pharmacy..

Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director provides medical..

Description The Medical Director actively uses their medical background, ... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG, clinical reference materials,..

Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... resources which may include national clinical guidelines, Humana contract language, Humana ... and determinations, medical necessity criteria, clinical..

Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical Director provides medical interpretation and determinations ... whether services provided by other healthcare professionals are..

... Medicare Appeals and Grievance Medical Director in Dover Delaware Description The ... Dover Delaware Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical..