Squared Group, a global professional services organization with over forty offices worldwide. For more information... program at any time, you will be able to simply send the word STOP. Please review our . Message and data rates may...
communicates such regulatory changes to organization through written communication and verbal presentations to designated... regulatory compliance experience, preferably in a health insurance or managed care environment required. Experience to include...
management, medical necessity criteria, appeals and grievances, peer review, accreditation standards, and managed care regulatory... and a minimum of two years of supervisory/leadership experience. Experience in utilization management, medical necessity review...
position supports daily operations, implementations, expansions, and administration of all Managed Services Accounts... and is knowledgeable of the tools and methods used for the completion of the Monthly Operations Review as directed · Performs...
(Strongly Preferred) Prior Experience in managed care, case management, utilization review, or discharge planning.... This position partners closely with Business Development, referral sources, managed care organizations, and facility leadership...
, and medical reviews to detect, prevent, deter, reduce fraud, waste, and abuse. We are looking to add a Medicaid Fraud Auditor..., claims analysis, documentation, and development of findings. Review individual workload during monthly auditor meetings...
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...
job duties and expectations, and are managed. Timely corrective action should take place when needed. Interface..., changes, ideas, and suggestions to drive the organization forward. Provide/facilitate training as needed. Ensure...
, vendors, and agencies from early concepts through final execution. Review artwork at each stage and provide clear, actionable... package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability...
need an agency that knows how to rock in a hard space. Since day one, Payer Sciences has approached managed markets..., Payer Sciences has assembled a flat and flexible organization, with analytics, consulting and communications living together...