to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers... include: - Collaborate with the Chief Medical Officer, Managed Care and executive leadership to develop, implement...
to align and drive toward shared goals. Responsibilities include: - Collaborate with the Chief Medical Officer, Managed Care... medical director for the Population Health Services Organization (PHSO) quality division. - Analyze Physician/APP KPIs...
Responsibilities: MAJOR DUTIES AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review... Review Medical Director to discuss quality of care and credentialing and state licensure issues. Maintain proper...
AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity... and workers’ compensation claims. Meets (when required) with Concentra Physician Review Medical Director to discuss quality...
Immediate need for a talented Atlassian Organization & Multiple Site Administrator (Engineering-Focused). This is a 06...+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the...
pricing and contracting customer strategies for product launches and educating the organization on managed markets issues... to build strategic relationships with national managed care accounts and their affiliates, regional accounts, and state...
in managed care experience preferred General working knowledge of the risk bearing organization and the delegated... over year, maximize client capitation revenue and manage client medical spend, coordinate the client team to ensure...
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives... to work in an effort that is seriously shaping the way health care services are delivered. As a Pre-Service Review Nurse...
-Service Review Nurse RN at UnitedHealth Group, you will make sure our health services are administered efficiently.... This is an inspiring job at a truly inspired organization. Ready to make an impact? ***Although this position is remote, applicants...
-Service Review Nurse RN at UnitedHealth Group, you will make sure our health services are administered efficiently.... This is an inspiring job at a truly inspired organization. Ready to make an impact? ***Although this position is remote, applicants...
management experience and requires a minimum of 2 years clinical, utilization review, or managed care experience..., ER, Telemetry, etc. strongly preferred. Utilization management/review within managed care or hospital strongly preferred. NICU...
. Responsibilities Process medical billing and follow up on claims with Medi-Cal and managed care payors Audit and evaluate clinical... in Behavioral Health medical billing, particularly with Medi-Cal and managed care Strong analytical and problem-solving skills...
🌟 We're Hiring: Medical Billing Specialist! 🌟 We are seeking a detail-oriented and experienced Medical Billing... Specialist to manage our healthcare billing operations. The ideal candidate will have strong knowledge of medical coding...
. Rotating Weekends and holidays. The Medical Management Nurse is responsible for review of the most complex or challenging... experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination...
, we are Better Together. As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental... above and beyond. If that sounds like an organization you want to be a part of, we would love to have you. ROLE OVERVIEW and PURPOSE...
As a member of the clinical support care team, the Medical Assistant - Referral Tracking obtains authorization.... Ensures that NEVHC receives proper consultative documentation back to Provider to review and to follow up on recommendations...
coverage review, member appeals clinical review, medical claim review and provider appeals clinical review Success...Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives...
coverage review, member appeals clinical review, medical claim review and provider appeals clinical review Success...Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives...
and organization; methods, techniques, practices, principles, and literature in the broad field of medical sciences The principles... of Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical Director - P&O) is responsible for the strategic...
. Neighborhood Healthcare PACE is a managed medical plan built around surrounding participants with a team of physicians, nurses...) community health organization, we serve over 500k medical, dental, and behavioral health visits from more than 100,000 people...