- Humana (Frankfort, KY)
- …are meeting the needs of the users and that they are compliant. The Associate Director , Market/Industry Insights delivers clinical insight and information to ... caring community and help us put health first** The Associate Director , Market/Industry Insights works closely with...external customers in order to ensure compliance of the Medicare clinical coverage policies. Meets regularly with… 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)
- **Become a part of our caring community and help us put health first** Associate Director of Project Management to join the Readiness and Recovery team, focusing ... on Experience and Transformation within Clinical and Service domains. This strategic leadership role is...service experiences, drive transformation, and support enterprise goals. The Associate Director will ensure alignment of project… 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
- 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
- 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)
- …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)
- …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)
- …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