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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 ..
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Description The Provider Contracting Professional 2 initiates, negotiates, and executes ... executes physician, hospital, and/or other provider contracts and agreements for an ... that provides health insurance. The Provider Contracting..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
... planning. Understands own work area professional concepts/standards, regulations, strategies and operating ... guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. The ... by our comprehensive contract. Visit..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
... Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, ... Senior Clinical Strategy and Practice Professional work assignments involve moderately complex ... Responsibilities The Senior Behavioral Health..
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..
