Clinical Strategy Manager Utilization Management Jobs in Charleston

... Professional will support development of strategy and lead execution of utilization strategy, including assignment of providers to ... on hours needed. Will provide non-clinical support for providers acting as..

... Information Humana Director, Behavioral Health Strategy in Charleston West Virginia Description ... Develop strategic initiatives for overseeing clinical integrity, especially for utilization and case management activities. This includes developing..

... 2 Medical Directors who conduct clinical case reviews of the care ... Medical Director for the Humana Clinical Operations Behavioral Division is looking ... will be responsible for Managing..

Job Information Humana Clinical Strategy Manager - Utilization Management in Charleston West Virginia Description ... Charleston West Virginia Description The Clinical Strategy & Analytics team is a ... value to..

... with questions and mentoring of clinical staff Reviews and resolves escalated ... Reviews inventory reports and assists management with data tracking to identify ... reviews for requested services using..

... points across members, providers, agents, clinical, care management, pharmacy, and other units. Accessibility ... high business acumen, digital product management skills and understands how to ... experience for benefits..

... resources which may include national clinical guidelines, Humana contract language, Humana ... and determinations, medical necessity criteria, clinical reference materials, internal teaching conferences, ... standards. Begins to influence department's..

Description The Director, Clinical Pharmacy Drug Evaluation and Policy ... Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, ... and providers. Responsibilities The Director, Clinical..