market databases and product review to analyze opportunities. Represents the enterprise and its specific businesses... and financing of health care services in the public sector managed care environment. Minimum Qualifications: Requires a BA/BS...
and/or certification in a managed care or utilization management organization preferred. Ability to understand clinical information... and external customers to help improve health outcomes for members. Works in collaboration with medical management and care...
on brand attributes. Collaborate with mechanical/electrical engineers and manufacturers. Participate in product review..., etc. In addition, Cella by randstad digital offers a comprehensive benefits package, including: medical, prescription, dental, vision...
. Provides the clinical information requested by the managed care companies as part of the concurrent review in a timely fashion... managed care organizations. 7. Participates in nursing orientation. 8. Interfaces with other departments in the Medical...
will report to SVP and Chief Medical Officer of Population Health and will also work closely with Ambulatory Lead for System... Oversee strategic design of polypharmacy review and medication reconciliation programs for high-risk ACO populations Support...
and prospect data, capture critical demographic and other information about existing and future residents, and review and analyze... – Makes good and timely decisions that keeps the organization moving forward. 6. Interpersonal Savvy – Relates openly...
edits to direct supervisor for review and resolution. Has a strong understanding of the Revenue Cycle processes... and policies. Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions...
by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products...Anticipated End Date: 2026-08-03 Position Title: Manager I Medical Mgmt Job Description: Manager I Medical Mgmt...
, and system stability Maintain an inventory and renewal of digital certificates across the organization, including SSL/TLS, code... recovery planning, test execution, and after-action review improvements. Documentation and Reporting Ensure all backend...
related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical... must be with a Managed Care Organization or Health Plan.For SelectHealth ETE Only: Experience in Public Health programming, delivery...