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... responsibility for trend management. *Oversee regional utilization management and case management ... communications. *Oversee administrative budget for regional HSO & Quality Improvement including ... offices and IPAs. *Participate in..
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... or community groups to support regional market priorities, which may include ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
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 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 ..
Description Responsibilities The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, ancillary and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires ..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..