- Humana (Frankfort, KY)
- **Become 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 work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Evolent (Frankfort, KY)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Frankfort, KY)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director ** Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Frankfort, KY)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Corporate Medical Director provides medical interpretation and decisions about the ... and determining the best course of action. The Corporate Medical Director provides medical interpretation...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing… more
- CenterWell (Frankfort, KY)
- …a part of our caring community and help us put health first** A ** Director of Authorizations & Eligibility** is a senior revenue cycle leader responsible for the ... payer approvals to protect revenue integrity and patient access. The Director partners closely with clinical leadership, operations, finance, compliance, and IT,… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Associate Director , Technology Solutions devises an effective strategy for executing and delivering on IT ... business initiatives. The Associate Director , Technology Solutions requires a solid understanding of how...ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote Travel: While this is a remote … more
- Humana (Frankfort, KY)
- …our caring community and help us put health first** The Associate Director , Technology Solution Implementation delivers new technological solutions to meet business ... a specified scope while aligned to enterprise objectives. The Associate Director , Technology Solution Implementation requires a solid understanding of how… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Associate Director , Service Offering Management enables and assures the management and abilities of the ... mission and needs of the whole enterprise. The Associate Director , Service Offering Management requires a solid understanding of...ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote Travel: While this is a remote … more
- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Director , Product Management Conceives of, develops, delivers, and manages products for customer use. ... The Director , Product Management requires an in-depth understanding of how...**Additional Information** **Humana Perks:** Full time associates enjoy: + Medical , Dental, Vision and a variety of other supplemental… more
- Humana (Frankfort, KY)
- …caring community and help us put health first** The Associate Director , Database Administration manages and maintains all production and non-production databases. ... data storage, maintenance, access and security administration. The Associate Director , Database Administration requires a solid understanding of how organization… more
- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Director , Product Management for CenterWell Pharmacy Digital leads the strategic vision, development, ... business objectives, including accelerating growth in payor agnostic markets. Additionally, the Director will lead a team of Product Owners (POs) and Product… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Director , Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other ... provider contracts and agreements for the State of Ohio. The Director , Provider Contracting requires an in-depth understanding of how organization capabilities… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Director , Provider Engagement develops and grows positive, long-term relationships with physicians, ... within the contracted working relationship with the health plan. The Director , Provider Engagement requires an in-depth understanding of how organization… more
- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Director , Business Systems Analysis leads the strategic advancement, optimization, and integration of ... initiatives that enhance provider experiences and streamline workflows. The Director requires deep expertise in business systems analysis, systems lifecycle… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Associate Director of Cloud Infrastructure Operations is responsible for leading Humana's enterprise cloud ... at the intersection of operations, technology, and AI innovation. The Associate Director of Cloud Infrastructure Operations will drive the evolution of Humana's… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Associate Director , IT PMO is accountable for the overall effectiveness, maturity, and delivery outcomes ... enable predictable, high‑quality execution of complex initiatives. The Associate Director partners closely with Portfolio Management, Finance, Cybersecurity, and… more