- CenterWell (Frankfort, KY)
- **Become 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- 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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Molina Healthcare (Lexington, KY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +...provider contracting experience. + Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice,… more
- Molina Healthcare (Lexington, KY)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- Molina Healthcare (Lexington, KY)
- …under-utilization. * Educates and interacts with network, group providers and medical managers regarding utilization practices, guideline usage, pharmacy ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ...leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. * Reviews… more
- Catholic Health Initiatives (Lexington, KY)
- …and Pharmacy Residents. May serve as the Residency Program Director or Coordinator if applicable to their location. **Job Requirements** **Requirements** ... -Graduate from an accredited school of pharmacy -Active KY Pharmacy license in good...practice and pharmacotherapies- Knowledge of Health Plans such as Medicare , Medicaid, and commercial plans -Demonstrates knowledge and skills… more
- Humana (Frankfort, KY)
- …best practices. Key responsibilities of the Senior Data Analyst, reporting to the Director , Pharmacy Digital Performance within Pharmacy Digital, include: + ... community and help us put health first** Our CenterWell Pharmacy Digital Performance team is looking for a Senior...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more