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Description The Provider Relations Executive is responsible for network provider training, education, and provider relations including the creation and management of provider and staff training curriculum and content, scheduling external training ..
Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
... population health goals and ensuring compliance with all contract, state, and ... local market lead for accreditation compliance. The Lead has oversight of ... oversight of quality investigations and..
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Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Profile The Medical Director actively uses..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Lancaster South Carolina ... South Carolina Description The Associate Director, Compliance Nursing reviews utilization management activities ... waste, and abuse. The..
Description The Transplant Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates transplant members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families ..
Description Responsibilities The Associate Director for ACD Audit , at ... ACD Audit , at the director of the Director of Payment Integrity, will create ... optimizing operational processes. The..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Title: Medical Director Location: Work..
Description The Medical Director actively uses their medical background, ... within a context of regulatory compliance, and work is assisted by ... work. Responsibilities Title: Commercial Medical Director Location: Work..
Description The Director, Health Services utilizes clinical nursing ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... segment. Responsibilities The SC Medicaid Director, uses clinical knowledge,..
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 actively uses..
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 Director, Provider Reimbursement is responsible for ... team of associates. Responsibilities The Director, Provider Reimbursement develops and executes ... and surveillance techniques to ensure compliance with government regulations...
Description The Lead Product Manager for Specialty products leads all phases of the product life cycle for Dental, Vision and Life products, from inception to introduction into the marketplace. Responsibilities Position ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
