- Humana (Frankfort, KY)
- …to the clinical operations team and healthcare organization. The Medical Director 's work includes computer based review of moderately complex to complex ... community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests for services. The ... Medical Director work assignments involve moderately complex to complex issues...is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Humana (Frankfort, KY)
- …our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The ... Corporate Medical Director works on problems of diverse scope and complexity...+ Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health, SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director ...guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests… more
- CenterWell (Frankfort, KY)
- …a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical ... Director , Primary Care work assignments involve moderately complex to...is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Humana (Frankfort, KY)
- …Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Frankfort, KY)
- …skills to make an impact** Additional Information Typically reports to a Regional/ Associate Vice President, Lead, or Corporate Medical Director , depending on ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to make determinations ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Frankfort, KY)
- …the Healthcare Quality Management Team in administering and implementing the Clinical Quality Management Program (CQMP) in support commitment to quality healthcare ... 2 collects and reviews records, summarizes issues, works with Medical Director as needed, and implements corrective actions as assigned. Coordinates case… more
- Signature Healthcare (Carrollton, KY)
- …number of Signature centers are earning Five-Star ratings from the Centers for Medicare & Medicaid Services. We were also named one of Modern Healthcare's "Best ... Signature Rehab's integrated care model rehabilitative therapist work closely with other clinical caregivers to ensure residents and patients make a full recovery… more