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Humana
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Providence, Rhode Island
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assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise
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Humana
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Providence, Rhode Island
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national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios
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Humana
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Providence, Rhode Island
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the opportunity to use your clinical knowledge, communication skills, and independent critical ... upgrade to compact licensure.
Three (3) or more years of progressive clinical experience
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Humana
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Providence, Rhode Island
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, and works directly to support business intelligence. Evaluates industry, economic, financial, and ... , 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are
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Humana
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Providence, Rhode Island
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Humana's Law Department is seeking a Counsel to provide legal advice and support for its national ... vendor, clinical and/or provider components. In addition, a portion of the work may comprise providing
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Humana
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Providence, Rhode Island
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which may include national clinical guidelines, CMS policies and determinations, clinical reference ... seminars on various behavioral health topics to the clinical operations team and healthcare organization
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Humana
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Providence, Rhode Island
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, and support staff.
Summary of Job Responsibilities:
Collaborate with business leaders, and ... and pay strategies that impact physician, advanced practitioner, and clinical pay trends and practices
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Humana
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Providence, Rhode Island
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MD will also support the Clinical Contracting Team to align on best practices, standardization in ... problems of diverse scope and complexity ranging from moderate to substantial.
Humana Clinical
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Humana
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Providence, Rhode Island
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of variable factors that rely on clinical experience and knowledge of both medicine and social ... include national clinical guidelines, state policies, CMS policies and determinations, clinical reference
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Humana
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Providence, Rhode Island
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resources, which may include national clinical guidelines, CMS policies and determinations, clinical ... complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily
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Humana
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Providence, Rhode Island
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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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Providence, Rhode Island
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experience
5 or more years of experience working with healthcare data (claims, clinical, provider ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits
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Humana
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Providence, Rhode Island
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legal advice and support for its national Medicare Advantage network operations. The position primarily ... , utilization management, and other similar arrangements with vendor, clinical and/or provider components. The
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Humana
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Providence, Rhode Island
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national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios
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Humana
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Providence, Rhode Island
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national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Medical Director's work includes computer based review of moderately complex to complex clinical scenarios
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Humana
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Providence, Rhode Island
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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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Providence, Rhode Island
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assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise
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Humana
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Providence, Rhode Island
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national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios
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Humana
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Providence, Rhode Island
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policies, clinical standards, and (in some cases) contracts. One weekend per month is required, with days ... assisted by diverse resources which may include national clinical guidelines, CMS policies and
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Humana
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Providence, Rhode Island
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System, and Jefferson Health System. Humana takes the lead in providing administrative support in various ... , Practice Transformation, Data Analytics, Post-Acute Care and Clinical Quality, and the opportunity to
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