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... Average, quartile payment information by provider, market, specialty, provider type Simulates cost/compliance approach, to ... our policy Evaluates risk Models provider utilization data from contracting activities (professional and hospital)..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, ... executes physician, hospital, and/or other provider contracts and agreements for an ... provides health insurance. The Senior Provider..
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Description The Payment Integrity Professional 2 uses technology and data mining, ... financial recovery. The Payment Integrity Professional 2 work assignments are varied and ... medical coding reviewer to handle..
Description The Process Improvement Professional 2 analyzes, and measures the effectiveness ... process improvements. The Process Improvement Professional 2 work assignments are varied and ... action. Responsibilities The Process Improvement..
Description The Business Systems Analysis Professional 2 performs analysis of business, process ... system requirement specifications for CarePlus' Provider Configuration and Load team. The ... team. The Business Systems Analysis..
Description Responsibilities This is a work at home position, Mon-Fri, 8am-5pm, with possible travel up 25%. The Senior Payment Integrity Professional contributes to overall cost reduction, by increasing the accuracy of ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
