- Humana (Richmond, VA)
- …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 (Richmond, VA)
- …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 (Richmond, VA)
- …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 (Richmond, VA)
- …help us put health first** Humana Healthy Horizons in Virginia is seeking an Associate Director , Care Management (LTSS/ABD) who will lead teams of healthcare ... and guide others in providing integrated services for the clinical teams. The Associate Director , Care Management requires a solid understanding of how… more
- Humana (Richmond, VA)
- …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 (Richmond, VA)
- …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 (Richmond, VA)
- …**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 (Richmond, VA)
- …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 (Richmond, VA)
- …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 (Richmond, VA)
- …us put health first for our members, providers and ourselves. Desired Lead Associate to lead and manage the enterprise framework to facilitate and document ... work closely with established functions inside utilization management (Medical Director , clinician decision making teams, quality audits, prior authorization list… more
- CenterWell (Henrico, VA)
- …expertise with the care team through daily huddles. + Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by ... primary care 'on-call' program of CenterWell as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your… more