Director, Clinical Operations (Utilization Management)
findings. Be an operational liaison between SFHP and contracted hospitals, IPAs, and providers regarding UM policies...
findings. Be an operational liaison between SFHP and contracted hospitals, IPAs, and providers regarding UM policies...
and follow-up of corrective action plans from contracted Independent Physician Associations (IPAs) and Health Plans Identifying...
, SOMOS, and Eastern Chinese IPA have seen that to succeed in a VBP world the IPAs and physicians must be supported by an integrated... financial risk attached to those contracts. The MSO must deliver administrative simplification for the PCPs and IPAs...
. Required Qualifications 3+ years of experience negotiating contracts with ancillary providers, facilities, physician groups, and IPAs...
in navigating structural and regulatory considerations, such as: multi-state organizational licensure (such as IPAs and ACOs...
systems and procedures (iPas, Data Manager etc.) Why join us? Work with to make a difference * Collaborate on exciting...
systems and procedures (iPas, Data Manager etc.) Why join us? Work with to make a difference * Collaborate on exciting...
codes, and healthcare networks including IPAs, HMOs, PPOs, PCPs, as well as contract affiliations and provider networks...
-Keene Act, Health & Safety Codes, etc., Familiarity with medical terminology, CPT codes, HCPCS codes, health networks, IPAs...
health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage Understanding of IPAs, Clinically...