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... most appropriate treatment, care or services for members. He/she will lead ... correcting over- or under-utilization of services. Will directly lead multiple managers ... highly specialized professional associates. Oversee..
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... in Louisiana is seeking a Manager, Claims Research & Resolution (Claims ... and consistent application of appropriate inpatient and outpatient medical necessity criteria. ... review and discharge planning of..
... and culturally-competent delivery of care, services, and supports in compliance with ... delivery of high-quality care management services, including introducing innovative approaches to ... seamless transitions for enrollees from..