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Humana
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Albany, New York
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Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to
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Humana
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Albany, New York
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review of moderately complex to complex clinical scenarios, review of all submitted clinical records ... assisted by diverse resources which may include national clinical guidelines, CMS policies and
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Humana
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Albany, New York
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which may include national clinical guidelines, CMS policies and determinations, clinical reference ... care, audit, grievance and appeal and policy review.
The Behavioral Health Medical Director will
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Humana
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Albany, New York
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Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to
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Humana
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Albany, New York
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problems of diverse scope and complexity ranging from moderate to substantial.
Humana Clinical ... .
The MD will also support the Clinical Contracting Team to align on best practices, standardization in
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Humana
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Albany, New York
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complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily ... resources, which may include national clinical guidelines, CMS policies and determinations, clinical
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Humana
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Albany, New York
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regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and
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Humana
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Albany, New York
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and pay strategies that impact physician, advanced practitioner, and clinical pay trends and practices ... execution of broader compensation projects. Build compensation team's knowledge on provider and clinical
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Humana
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Albany, New York
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.
The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of
...
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Humana
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Albany, New York
...
Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to
...
-
Humana
-
Albany, New York
...
review of moderately complex to complex clinical scenarios, review of all submitted clinical records ... assisted by diverse resources which may include national clinical guidelines, CMS policies and
...
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Humana
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Albany, New York
...
Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to
...
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Humana
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Albany, New York
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Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and ... the appropriate courses of action.
The Utilization Management Nurse 2 uses clinical knowledge
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Humana
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Albany, New York
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policies, clinical standards, and (in some cases) contracts. One weekend per month is required, with days ... appropriateness of services provided by other healthcare professionals in compliance with review policies
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Humana
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Albany, New York
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area.
Performs or oversights the timely and comprehensive review and response to TRICARE ... Nursing, Healthcare Administration or other related field
MCG Criteria knowledge and prior clinical
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