• Director , Medicare Certified

    Queen's Health System (Honolulu, HI)
    …Emma and King Kamehameha IV. Area(s) of assignment: Directs and oversees Medicare Certified Division by developing and implementing strategic and innovative ... RESPONSIBILITIES Effective Date: 06/25 I. JOB SUMMARY: A Director functions at a high organizational level, providing leadership and direction in the development and… more
    Queen's Health System (07/22/25)
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  • Medical Director - Medicare

    Humana (Honolulu, HI)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals.… more
    Humana (07/23/25)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Honolulu, HI)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... 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… more
    Humana (06/18/25)
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  • Medical Director - South Central

    Humana (Honolulu, HI)
    …outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or ... Bold Goal mission, throughout all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services more
    Humana (07/11/25)
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  • Sr Analyst, Scope Management

    Evolent (Honolulu, HI)
    …comprehensive management of prior authorization and financial scope within Evolent Specialty Services . Reporting to the Director , Clinical Informatics, this role ... sources, including the American Medical Association (AMA), Centers for Medicare & Medicaid Services (CMS), Food and...such as: + Registered Health Information Technician (RHIT) + Certified Hematology and Oncology Coder (CHONC) + Certified more
    Evolent (07/18/25)
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