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Job Information Humana Medical Director - Texas in Portsmouth New Hampshire Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
... or community groups to support regional market care facilitation and priorities, ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
... is a national leader in healthcare staffing recognized by Staffing Industry ... one of the nation's largest healthcare staffing firms. Our goal is ... Our clients range from local,..
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 ..
... as directed by the Clinical Manager. Confer with physician in developing ... with physician orders, under Clinical Manager's supervision. Revise plan in consultation ... Coordinate appropriate care, encompassing various..
... Portsmouth New Hampshire Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... across the enterprise to support..
... 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 Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
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 ..
... any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, ... contact with patients, physicians, clinical manager(s), other members of the healthcare team in a timely manner .....
... Portsmouth New Hampshire Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
... of services provided by other healthcare professionals in compliance with review ... or community groups to support regional market priorities, which may include ... whether services provided by other..
... preference with judicious use of healthcare resources Educates physicians regarding InterQual ... for high-risk patients across the healthcare continuum. Ensures the delivery of ... is a national leader in..
