with other health care professionals, member and/or family Refers cases to medicalreview according to policy and procedure Documents... medical records on site, through remote electronic access, telephonically or by fax in a collaborative effort...
Anticipated End Date: 2025-12-23 Position Title: Medical Management Specialist I Job Description: Medical... as required by law. Schedule: M-F 8AM to 5PM EST, no weekends or holidays. The Medical Management Specialist I is responsible...
Anticipated End Date: 2026-01-12 Position Title: Medical Mgmt Specialist I Job Description: Location: This role... requires travel to our Washington, D.C. office 4 days each week. The office is located at 609 H. Street NE. The Medical...
team from Brand Marketing, Commercial Operations, Sales Leadership, US Medical Affairs, Strategy Customer Group (SCG), Real..., campaign evolution, agency oversight, PRC/regulatory review, and community, outpatient and field reimbursement optimization...
A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS... met. Ensures requirements are managed, objectives and appropriate performance and service-level metrics are defined for IT programs...
medicalreview experience requiring guidance by more senior colleagues and/or management. Partners with more senior... medical necessity review. Conducts initial medical necessity review of exception preauthorization requests for services...
;assist in referrals to specialists if needed;assist in obtaining durable medical equipment, review pricing for high-cost... care guidelines to compare patient’s current level of care with industry standards. Use claims processing tools to review...
. Become an anti-racist organization Create an equitable work environment. About the Role Responsible for the operational... members with short term, long term, stable, unstable, and predictable course of illness, and/or highly complex medical...
intensive screening of all Medicare, Medicaid and managed care patients to identify network status and coordination of benefits.... Must adhere to the Medical Center's Quality Standards and maintain a positive patient experience at all times. Responsibilities...
in Indianapolis IN, is a certified woman-owned (WBE) professional services organization with over 1500 employees located in offices... in Managed Service Programs (MSP), Employer of Record / Payrolling Services, National Recruitment, and Staffing Services...