Associate Director Healthcare Clinical Jobs in Springfield

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 Medicaid Associate Director, Compliance Nursing in Springfield Missouri ... in Springfield Missouri Description The Associate Director, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. 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 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..

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

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 ..

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..

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

... and Risk Adjustment National Medical Director in Springfield Missouri Description The ... in Springfield Missouri Description The Healthcare Quality Reporting & Improvement (HQRI) ... and 3) contribute as a..

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..

... 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..

... more information, please contact:Erika Flewellen, Associate RecruiterPhone: 405-752-3528Email: Erika.Flewellen@Mercy.NetAA/EEO/Minorities/Females/Disabled/Veterans Visit our ... an essential function of this job.,industry:Healthcare,title:NP Clinical Specialist - Cardiac Med Telemetry ... - Disease Management, Registered..

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

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

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

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

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,..

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'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 Medical Director - Texas in Springfield Missouri ... Springfield Missouri Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work..

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..