effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors... experience is preferred. Minimum 2 years’ experience in acute care setting is preferred. Managed Care experience is preferred...
Description : In this role, you will: Act as liaison between managed care organizations and the facility...’s professional clinical staff. Conduct reviews in accordance with certification requirements of insurance plans or other managed...
and development of product initiatives as directed by the product manager. This position works across the organization by leading the... and development of product initiatives. Maintain existing commercial medical products and implement changes to commercial medical...
best practices. Coordinate MOC workflow to ensure compliance and changes are being managed proficiently. Review all start up... responsible to all affected personnel. Review all Process Safety Events and associated incident investigations. Participate...
to individuals;modifications and updates to TMHP vendor systems;and encounter data and Managed Care Organization (MCO) file support... service Comprehensive benefits package, including: Medical insurance (with employer cost sharing) Life insurance A 401...
policy review, and regulatory compliance. This role is responsible for evaluating the financial and operational impact... of payer policies, government reimbursement regulations, and healthcare legislation. The analyst partners with managed care...
Technical Product Manager Description - This role will be part of the Technology and Innovation Organization (TIO..., customers and will have high visibility and be a key contributor to the organization. Furthermore, the TPM will keep track...
. Growing together. The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication.../Department of Managed Healthcare, and CMS regulatory responses Communicate with UnitedHealthcare medical directors regarding...
insurance Florida Doctors Group is seeking an experienced Medical Coding Specialist with a strong background in managed care... to join our team. This role requires a detail-oriented professional who understands medical coding guidelines, managed care workflows...
managed testosterone replacement therapy (TRT), weight management, skin care, and concierge medicine — helping men look... measurable results. Daily responsibilities include: Conducting new patient consultations, reviewing medical histories...