Specialist Jobs

Job Information Humana Care Team Medical Director in Honolulu Hawaii Description The Care Team Medical Director is responsible for improving the quality of care and outcomes while managing costs for a ..

Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..

Job Information Humana Clinical Pharmacy Lead, Remote in Honolulu Hawaii Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Honolulu Hawaii Description Humana is looking for an experienced Healthcare Investigator to join its industry ..

Job Information Humana Medical Director - National Medicare Team in Honolulu Hawaii Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Honolulu Hawaii Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

Job Description Kapi'olani Medical Specialists (KMS) is a specialty physician group dedicated to caring for Hawai'i's women and children through excellence in academics, physician training, medical research and clinical care. The ..

Job Information Humana FP&A Lead, Medicaid Market in Honolulu Hawaii Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..

Job Information Humana UM Medical Director - Conviva in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

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 ..

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 ..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Honolulu Hawaii Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..

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 ..

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 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 Description Founded in 1921, Straub Medical Center includes a 159-bed hospital in Honolulu, a network of neighborhood clinics and a visiting specialist program that reaches throughout the state of Hawai'i. ..

Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Honolulu Hawaii Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special Investigations ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Honolulu Hawaii Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

Job Information Humana Medical Director - Florida Medicaid in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

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 ..

Job Information Humana Care Management Support Specialist in Honolulu Hawaii Description A day in the life of a CMSS would consist of being aligned to one of over 6 different tasks ..

Job Information Humana Medical Director - S. Florida in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

An innovative and fully integrated health system is recruiting for BE/BC Family or Internal Medicine physicians for two practice locations. u00a0 * Employed, full-time position * Outpatient Primary Care practice * ..