. 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...
Experience in a managed care organization Knowledge of Interqual or MCG Pay is based on several factors including... management of hospitalized health plan members. You will ensure patients receive quality medical care in the most appropriate...
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...
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...
review plan 9. Ensure compliance with all federal, state, and local regulations, as well as organization policies.... 3. Provides appropriate reviews to multiple health plans/medical groups via agreed upon methods (telephone, fax...
+ NDCs across 300+ managed contracts, which are managed by 25+ customer facing health system/National GPO/Trade Directors... Demonstrated ability to achieve results across a matrixed organization Documented ability to lead innovation and develop...
of IntegriChain’s Access Management Operations organization, which provides managed services and business process outsourcing... for review and maintenance of key master data utilized within all Government Pricing calculations. Manages the clients’ class...
managed by engineers today. Every member of our team has a personal stake in ensuring the success of our clients. As employee..., as requested by the Technical Services Director, to promote continuous learning and knowledge-sharing within the organization...
of IntegriChain's Access Management Operations organization, which provides managed services and business process outsourcing... for review and maintenance of key master data utilized within all Government Pricing calculations. Manages the clients' class...
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...