THE LARGEST COLLECTION OF JOBS ON EARTH
managerial
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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..
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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..
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 ..