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Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director actively uses..
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Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
... The Lead Behavioral Health Medical Director oversees the work of 2 ... The Lead Behavioral Health Medical Director may also lead specific functional ... Directors. Responsibilities The Lead Medical..
Description The Medical Director relies on fundamentals of CMS ... relies on fundamentals of CMS Medicare Guidance on following and reviewing ... following and reviewing appeals for Medicare Part C..
... meet medical necessity and other Medicare and/or Medicaid criteria if applicable, ... the Chief Medical Officer (CMO)/Medical Director to review PA requests. The ... outpatient procedures pursuant to applicable..
