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... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... Behavioral Health Professional 2 completes medical record reviews from medical records sent from Behavioral Health ... appropriate..
Description The Lead Medical Director relies on medical background and reviews health claims. ... reviews health claims. The Lead Medical Director requires a solid understanding of ... across department(s). Responsibilities..
Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
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 Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Commercial requirements ... daily work. Responsibilities Title:..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description The Lead Product Manager for Specialty products leads all phases of the product life cycle for Dental, Vision and Life products, from inception to introduction into the marketplace. Responsibilities Position ..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... of variable factors. Responsibilities..
Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description The Vendor Quality Medical Director will manage clinical vendor quality ... Team. Responsibilities A full time Medical Director to manage clinical vendor quality ... to review quality audit findings,..
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, Utilization Management Nursing utilizes clinical ... coordination, documentation and communication of medical services and/or benefit administration determinations. ... benefit administration determinations. The Associate Director, Utilization Management..
... brand for a primary care medical group practice with centers open ... of care. Follows level of medical care and quality for patients ... hospital and SNF coordination, durable..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities Job..
... Responsibilities Title : Clinical Trend Medical Director Assignment: Enterprise Clinical Management, Clinical ... is seeking a Clinical Trend Medical Director. As a clinical trend leader ... that will positively..
