• Behavioral Health Medical Director

    Humana (Madison, WI)
    …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...authorized. All work occurs within a context of regulatory compliance and work is assisted by diverse resources which… more
    Humana (08/07/24)
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  • Medical Director - National Medicare

    Humana (Madison, WI)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources, which...and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will… more
    Humana (08/29/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Madison, WI)
    …our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The ... Corporate Medical Director reviews cases of diverse scope and complexity ranging...and appropriateness of services rendered by healthcare professionals in compliance with CMS guidelines, clinical coverage criteria, and quality… more
    Humana (08/10/24)
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  • Medical Director - Mid West Region

    Humana (Madison, WI)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more
    Humana (08/27/24)
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  • Medical Director - Southeast Region

    Humana (Madison, WI)
    …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 ... requires an in-depth evaluation of variable factors. **Job Profile** The Medical Director actively uses their medical background, experience, and judgement to make… more
    Humana (08/20/24)
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  • Medical Director - Acute Inpatient…

    Humana (Madison, WI)
    …**Additional Information** Typically reports to a Lead, may also report to a Regional/ Associate Vice President or Corporate Medical Director , depending on size ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
    Humana (08/27/24)
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  • Home Health RN Clinical Director DON 15k…

    Aveanna (Madison, WI)
    Home Health RN Clinical Director DON 15k Sign On Bonus ApplyRefer a FriendBack Job Details Requisition #: 195748 Location: Madison, WI 53703 Category: Nursing ... incentive plan and $15k Sign-On Bonus ** Position Overview TheClinical Director Home Healthis a qualified professional responsible for the planning, coordination,… more
    Aveanna (08/15/24)
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  • Director , Actuarial of Medicaid Pricing

    Humana (Madison, WI)
    …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
    Humana (08/15/24)
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  • Director , Provider Activation

    Humana (Madison, WI)
    …a part of our caring community and help us put health first** The Director , Provider Activation is responsible for the end-to-end process of adding providers to ... increase productivity, and oversees execution of relevant initiatives. The Director , Provider Activation motivates, manages, and leads high-performance teams… more
    Humana (08/31/24)
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  • Risk Management Lead - Regulatory…

    Humana (Madison, WI)
    …Legislation Regulation and Requirements (LRR) Database + Serve as backup to the Associate Director , exercising independent judgement and decision making + Review ... + PMP or Six Sigma Certification **Additional Information** You will report to the Associate Director of Operational Risk Management. This area is under the… more
    Humana (08/23/24)
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  • Tax Lead

    Humana (Madison, WI)
    …seeking a Federal Income Tax Lead responsible for leading the Federal income tax compliance and audit functions to minimize the company's tax burden and maintain its ... payments. + Lead Federal tax examination and appeals processes under IRS Compliance Assurance Process ('CAP' or 'CAP Maintenance'). + Manage Humana's corporate… more
    Humana (08/06/24)
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  • Senior Risk Adjustment Administration Professional

    Humana (Madison, WI)
    …coding, and provide feedback to physicians regarding documentation practices and compliance with state and federal regulations. + Cultivate effective partnerships in ... a matrix environment of coding educators, medical director , clinical and market operations. + Facilitate, track and trend for reporting to leadership and… more
    Humana (08/29/24)
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