accurate and timely documentation, records, and case files in the PartnershipHealthPlan of Californica (Partnership) Case... use disorders Valid California driver’s license and proof of current automobile insurance compliant with Partnership...
software including Windows, Microsoft Word, Excel, Outlook, Visio, and PowerPoint. Valid California driver’s license and proof... of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company...
Overview: To direct, develop, implement and coordinate medically necessary treatment services within Partnership... with established guidelines and workflows. ▪ Maintains accurate and timely documentation, records, and case files in the Partnership...
, Partnership Claims Operating Instruction Memorandums, State of California Medi-Cal Provider Manual guidelines, Title 22... Report. - Routes claims to appropriate Partnership departments and internal staff for additional review. Follows up...
of communication with members, providers, vendors, community partners, and Partnership employees. ▪ Coordinates referrals..., and case files in the Partnership ▪ Case Management System for members in case management. ▪ Applies evidence-based...
requirements, NCQA specifications, and Partnership professional standards. Conducts individual audits of grievance, appeal, exempts... or expedited basis Assesses cases to determine if DHCS-mandated timeframes, NCQA specifications, and Partnership professional...
compliance with established criteria and Partnership benefits. Responsibilities: Provides day-to-day direction to Utilization... to the Director of Utilization Management as requested. Assists Partnership staff and providers with the interpretation...
with understanding PartnershipHealthPlan of California's policies and procedures and assists with resolving issues that arise... Visit Sheet. Investigates and responds to provider concerns. Serves as neutral liaison between providers and Partnership...
accurate and timely documentation, records, and case files in the PartnershipHealthPlan of Californica (Partnership) Case... use disorders Valid California driver’s license and proof of current automobile insurance compliant with Partnership...
management and staff, external clients and vendors. Valid California driver’s license and proof of current automobile insurance... compliant with Partnership policy are required to operate a vehicle and travel for company business. Performance Based...