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... clinical scenarios predominantly arise from inpatient, post-acute care environments, outpatient service ... outpatient service requests, ER review, pharmacy review work, and sometimes appeals ... authorization and retrospective reviews for..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
... Managing Clinical Pharmacist within the Pharmacy Claim Audit & Review department ... The Managing Clinical Pharmacist - Pharmacy Claim Audit & Review will ... pharmacies are dispensing appropriately. The..
... authorization and retrospective reviews for inpatient and outpatient services to ensure ... clinical scenarios predominantly arise from inpatient, post-acute care environments, outpatient service ... outpatient service requests, ER review,..
About this job Find your commute Overview: Grow your career! At EmpowerMe Wellness, you'll find opportunities for promotion, continuing education, and great benefits, all while making a real difference in the ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
