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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 ..
Our Morristown location covers the following counties: Claiborne, Grainger, Cocke, Hamblen, Jefferson, Hancock SOME OF OUR PERKS: Daily pay Option Available! No need to wait until payday! We offer retention bonus ..
Job Information Humana Senior Accreditation Professional in Brentwood Tennessee 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 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 ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
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 ..
Caregivers Wanted in Kodak, TN Acti-Kare, the premier provider of senior and home care services, is currently seeking experienced caregivers to assist adult clients in their homes. Full-time and part-time available. ..
Description The Staff Clinical Pharmacist- Clinical Formulary Administration monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge ..
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 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 ..
Job Information Humana Actuary, Risk and Compliance in Brentwood Tennessee Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..
