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Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate ..
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... to the member's physician and medical director for appropriate interventions Works closely ... case managers, attendings, PCP and medical director, community agencies and other approved ... patients with acute..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Profile..
Description The Transplant Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates transplant members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families ..
Description The Associate Director, Grievances & Appeals manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request ..