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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 ..
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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 The Clinical Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also pulls ..
Job ID 21000H3WAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u0026nbsp;u003c/strongu003eu003c/pu003enu003cpu003eu003cemu003eAre you considering a career move away from direct patient care and want to use your nursing knowledge in a new and different way? If you desire a remote ..
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u003cpu003eu003cstrongu003eRole Summary: u003c/strongu003eProvide analytical, administrative, and technical assistance in meeting goals of annual Medical Review strategy through development and maintenance of a variety of databasesu003c/pu003enu003cpu003efor monitoring, recording, and reporting purposes. Perform ..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
Direct Care Workers provide services such as respite services, personal care, meal preparation, medication administration or housekeeping services. Requirements: 18 years of age or older Current CPR certification Current First Aid ..
Submit an online application to: https://easyapply.co/job/caregiver-568?rcid=mycnajobs Caregivers with SYNERGY: Provide reliable care attending to clients’ non-medical needs. Light housekeeping, meal preparation, and medication reminders Transportation to Dr. appointments and shopping SYNERGY ..
Description The Clinical Services Pharmacy Technician takes calls from patients, pharmacies and providers, and performs varied activities and moderately complex administrative, operational, and customer support assignments. The Clinical Services Pharmacy Technician ..
Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The Pharmacy ..
Home Care for the 21st Century is hiring CNAs for all shifts and days - build your own schedule. PRN, part time, or full time. Competitive pay, flexible schedule. Please have ..
Job Information Humana Senior Accreditation Professional in Phoenix Arizona Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with ..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
Loving what you do for a living is one of the most rewarding endeavors one can have. Do you want to make a difference? If so Golden Heart Senior Care is ..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..