- Humana (Lansing, MI)
- …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... requires a case by case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director will collaborate with clinicians and… more
- Centene Corporation (Lansing, MI)
- …teams to optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing ... perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the...complex cases and medical necessity appeals . + Participates in provider network development and new… more