applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering...Anticipated End Date: 2026-04-01 Position Title: Manager I Medical Management Job Description: JR186273 Manager...
, spelling, and formatting. Ensure required regulatory hedge language, disclosures, and copyright marks are included;may review... digital offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance...
.E.D. 3-4 years experience in a managed care organization, hospital or physician’s office with 1 year referral experience... of the Referral Process Collects all referrals from medical staff daily and obtains any necessary approvals from attendings...
regarding payment issues;establish reasonable payment arrangements;recommend adjustments according to UPMC policies;review... and assign appropriate status codes;and review high dollar accounts on a regular basis. The Account Representative, Senior...
TN. At Ageless, we focus on medically managed testosterone replacement therapy (TRT), weight management, skin care..., reviewing medical histories, and performing physical assessments. Ordering, reviewing, and interpreting lab work and diagnostic...
effective acute and ambulatory case management, utilization management and claims review activities, to ensure appropriate, cost.... Required Qualifications Other Graduate of an NLN-accredited School of Nursing 2 Years Behavioral Health and Medical Nursing experience...
requests for specialty outpatient care, retrospective claim review, medical equipment, medication issues and acquisition, home.... Required Qualifications Successful completion of Medical Assistant Program or equivalent work experience. 3 Years Working in the managed...
-minded Production Financial Planning & Operations Analyst to help transform how a high-volume creative organization manages... production financials are accurately represented within the broader creative organization, partnering closely with financial...
methodologies across the enterprise. Works with medical directors, contract negotiators, cost of care staff and provider relations..., or Healthcare Administration is highly preferred. Experience in broad-based, analytically oriented, managed care payor or provider...
Psychologist Reviewer - part time is responsible for collaborating with providers and Medical Directors to determine... appropriateness of level of care based on Medical Necessity Criteria. Outpatient levels of care include Psychological Testing...