Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management pr...
Job Description: The Cybersecurity Analyst develops and implements a comprehensive information security programs including defining security policies, processes and standards. They perform audit assessments and define processes and standa...
Duties Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health mana...
Duties Responsible for daily workflow activities to include the following membership/enrollment activities: processing of applications for new enrollments, terminations/cancellations, changes, renewals, and database updates. •50% Receives...
Duties Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health mana...
QA Specialist (Shifts) Provide Quality and Compliance oversight for manufacturing of commercial and investigational products through Shop Floor presence. Responsible for performing inspection and disposition of raw materials and component...
Duties Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health mana...
Job Description: JOB DUTIES: Provide single session onsite presentations for Company's employer groups and the community on a wide variety of chronic condition, care, and wellness topics such as diabetes management, hypertension, and lifes...
Duties Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims a...
Description: Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted. Manages all aspects of investigative activity on complex claims. D...