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... RVP Health Services (CMO)relies on medical background to create and oversee ... needed) The CMO will provide medical leadership and strategy for the ... for inpatient cases (acute care..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Commercial requirements ... daily work. Responsibilities Title:..
Job Information Humana Care Team Medical Director in Lancaster South Carolina ... Carolina Description The Care Team Medical Director is responsible for improving ... ground up. The Care Team Medical..
... neonatology services at both Piedmont Medical Center in Ft. Mill, SC ... Ft. Mill, SC and Piedmont Medical Center in Rock Hill, SC. ... in Rock Hill, SC. Piedmont..
Description The Behavioral Health Medical Director makes determinations regarding prior ... Humana coverage policies and determinations, medical necessity criteria, clinical reference materials, ... conferences, and other reference sources. Medical Directors..
Description Humana's Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 175 centers across eight states under two ..
... Stars and Risk Adjustment National Medical Director in Lancaster South Carolina ... clinical industry representative. As a leader, this role leads HQRI's Provider ... nationally. This role relies on..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Medicare and ... their daily work. Responsibilities..
Description The Medical Director relies on fundamentals of ... C Line of Business. The Medical Director provides medical interpretation and determinations whether services ... a rotating basis Responsibilities The Medical..
Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Lancaster South Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to ..
... and documents in the patient medical record, adjusts or modifies the ... as indicated and notifies Team Leader, Charge Nurse, Clinical Manager or ... approved algorithm(s), and documents appropriate..
... we do. The Divisional Chief Medical Officer (CMO) is an entrepreneurial ... an entrepreneurial & experienced physician leader committed to the principles of ... will be a proven clinician,..
Description Humana is a Fortune 50 market leader in integrated healthcare delivery. As a company whose primary focus is on the well-being of its members, Humana is dedicated to shifting perceptions ..
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 for Humana's Kentucky Medicaid Plan. The Utilization ..
Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly owned subsidiary of Humana, ..
Description The Lead Behavioral Health Medical Director oversees the work of ... oversees the work of 2 Medical Directors who conduct clinical case ... themselves. The Lead Behavioral Health Medical..
Job Information Humana UM Medical Director - Conviva in Lancaster ... Lancaster South Carolina Description The Medical Director relies on medical background and reviews health claims. ... and reviews health..
Description The Medical Director's primary responsibility is the ... responsibility is the review of medical authorizations or claims to determine ... or claims to determine the medical necessity of a..
Description The Director, Physician Leadership relies on medical background and reviews health claims. The Director, Physician Leadership requires an in-depth understanding of how organization capabilities interrelate across the function or segment. ..
... for the PCO University. Monitor medical performance and provide guidance to ... years' experience in clinical practice Medical staff leadership experience for a ... practice, physician practice management organization,..
