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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 Senior Contract Tools, Education, Processes Professional - ... Meridian Idaho Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..
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 Medicare Appeals and Grievance Medical Director in Meridian Idaho 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 Meridian Idaho Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Medical Director - Florida Medicaid in Meridian Idaho Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Admin / Clerical (188) Advanced Practice Registered Nurses / Physician Assistants (339) Allied Health (3185) Executive (81) Operations (252) Physicians/Surgeons (1354) Quality/Risk Management (19) Type Contract (1) Fellowship (0) Full Time ..
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, ..
... market contracting teams to influence specialist contract terms that align with Service ... in close coordination with PCP Contract Load, Capitation Rates, Payments, and ... Adjustments teams to ensure..
Job Information Humana Medical Director - National Medicare Team in Meridian Idaho Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
... The Provider Contracting Executive communicates contract terms, payment structures, and reimbursement ... settlement arrangements (with finance)Delivers a contract that can be operationalized, and ... be operationalized, and maintained.Collaborates with..
Job Information Humana FP&A Lead, Medicaid Market in Meridian Idaho Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Admin / Clerical (0) Advanced Practice Registered Nurses / Physician Assistants (3) Allied Health (0) Executive (48) General Nursing (0) Operations (0) Physicians/Surgeons (4691) Quality/Risk Management (0) Type Contract (3) Fellowship ..
Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Meridian Idaho Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..
Advanced Practice Registered Nurses / Physician Assistants (84) Executive (8) General Nursing (108) Nursing Support (2) Operations (1) Physicians/Surgeons (166) Type Contract (0) Fellowship (1) Full Time (71) Locum Tenens (0) ..
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 ..
