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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 ..
Clinician/ Intake Specialist, Flexible Schedule, Sign-on bonus (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Crisis Clinician/ Intake Specialist (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof of vaccination must ..
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 ..
Description Job Description Summary 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 ..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..
Crisis Clinician/ Intake Specialist **3,000 Sign on bonus (Full Time) Location: Providence,RI **3,000 Sign on bonus Position Summary: Exciting opportunity to become a member of our dynamic behavioral health emergency services ..
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 Newport Rhode Island Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
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 ..
Crisis Clinician/ Intake Specialist, Flexible Schedule, Sign-on bonus (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. ..
Job Information Humana UM Medical Director - Conviva in Newport Rhode Island Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
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 ..
Crisis Clinician/ Intake Specialist (Full Time) Location: Providence,RI Position Summary: Exciting opportunity to become a member of our dynamic behavioral health emergency services team. As a member of this team, you ..
