Humana·14 days ago
14 days ago
Medical Director – Medicare Pharmacy, VSP
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What you'll do
- review Medicare drug appeals
- collaborate with clinicians to deliver value-based care
What they're looking for
- board certification (internal medicine, family medicine, emergency medicine, physical medicine and rehabilitation)
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
Join us as a Medical Director – Medicare Pharmacy, VSP, where you will utilise your clinical expertise to review Medicare drug appeals and collaborate with clinicians to deliver value-based care. This role suits an experienced physician with strong analytical skills and a commitment to regulatory compliance.
Skills
- integrated delivery systems
- business metrics
- medicare advantage requirements
- medicare part b appeals review
- medicare part d appeals review
- utilization management
- clinical data analysis
- public health analytics
- national coverage determinations
- clinical pharmacology
- humana pharmacy policies and procedures
- board certification (internal medicine, family medicine, emergency medicine, physical medicine and rehabilitation)
- clinical group practice management
- team collaboration
- medical necessity analysis
- inter- and intra-departmental collaboration
- health insurance knowledge
- population health analytics
- quality management
- cms policies
- managed care industry knowledge
Company
Humana
Nationwide, United States of America
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