and appeals to determine medical necessity, appropriateness of services, interprets benefits and limitations, and reviews... Quality Improvement Committee as requested by the Chief Medical Officer/ May work with community provider committees...
with oversight and guidance from the classroom teacher and program director in carrying out the essential duties and responsibilities... or equivalent w/ passage of basic skills test. Associate degree or higher in education or a closely related field of study...
for each position. Ensures delivery of highest level of customer service to the community and its medical providers. Responsibilities... for Senior Claims Director’s review. Participates in the review of Claims Operating Memorandums, recommends changes...
in absence of the Associate Director, Data Warehouse and Architecture. * Responsible to train new staff on ETL architecture... with experience in medical information systems; or equivalent combination of education and experience. Experience with healthcare...