JOB SUMMARY: The Medical Director will exhibit strong expertise in utilization management and health plan leadership... experience in their specialty. Previous experience as a Medical Director with a health plan, managed care, or health insurance...
Job Description: Job Overview We are seeking an experienced and dedicated Medical Director to provide clinical...) Job Summary The Medical Director will oversee and guide the clinical operations of partner facilities, ensuring that patient...
aspects of medical policies and programs. Performs medical reviews and interacts with the provider communities for assigned... or territory of the United States Maintain Board Certification by a specialty board approved by the American Board of Medical...
and refers cases that do not meet established clinical criteria to the Medical Director. Appropriately identifies and refers... indicated. Determines medical necessity and appropriateness of services using clinical review criteria. Accurately documents...
and refers cases that do not meet established clinical criteria to the Medical Director. Appropriately identifies and refers... indicated. Determines medical necessity and appropriateness of services using clinical review criteria. Accurately documents...
of complex claims for further research meeting the MRE “pend” criteria. Collaborate with Medical Director...JOB SUMMARY: The Medical Review Examiner Nurse is responsible for auditing provider and facility claims. Identifying...
Title: Medical Coder (ENT Specialty) Pay Rate: $24-$27/hour Reports To: Practice Manager or Director of Revenue Cycle...Tulsa, OK Order: 1709120 Order Type : TempToFT Job Description: Medical Coder - ENT Clinic-Tulsa, OK Position...
Tulsa, OK Order: 1707799 Order Type : TempToFT Medical Billing Specialist Monday-Friday 8am-5pm | $18-$23... as needed. Assess aged accounts to establish adjustment recommendations. Post insurance and patient payments using medical billing...
. Assisting the Medical Director and Quality Program Director with development and implementation of medical staff quality...Overview Critical Illness Recovery Hospital Director of Quality Management At Select Specialty/Regency Hospitals...
Job Description: Join our team as a part-time, Dietary Services Director in Tyler, TX. Why Join Us? Thrive..., offering state-of-the-art MRI, computed tomography and myelography technology. The Director of Food and Nutrition Services...
Description & Requirements The Director of Federal Subcontracts Governance and Training will lead the development... for leading internal initiatives including compliant practices within acquisition-related functions. The Director will establish...
Clinical Director, you will assists the Executive Director in all functions of clinical oversight of the provider... all patient care activities to ensure compliance with current standards of accepted nursing and medical practice and regulatory...
Description & Requirements Maximus is hiring a Consulting Managing Director to lead strategic expansion... Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts...
of our employees. This position reports to the Director of Finance, Controller with responsibility for financial planning... to guide optimal capital allocation. Serves as a valued financial advisor to Director of Finance, Controller, President...
of our employees. This position reports to the Director of Finance, Controller with responsibility for financial planning... to guide optimal capital allocation. Serves as a valued financial advisor to Director of Finance, Controller, President...
JOB SUMMARY: The Director of Risk Adjustment is responsible for the strategic design, implementation, and oversight... management Lead cross functional teams including coding, analytics, compliance, medical economics and operations to ensure...
knowledge and supervisory experience to lead an amazing team of clinicians as their Clinical Director. If you are an RN..., shaping a world of care for patients and families. Collaborating closely with your Program Director, Hospice Physician...
JOB SUMMARY: The Director Actuary will coordinate work with CCOK’s external actuaries, work closely with Marketing.... The Director Actuary will have deep Health Insurance experience and a particular focus in Medicare Advantage, to direct...
to direct clinical programs, including Patients-At-Risk. Rotate attendance with Medical Director at PBM National P&T meetings... utilization management determinations. Work with the Medical Director and pharmacy help-desk in the review process of prior...
Assistant Director of Clinical Research is responsible for leading and managing clinical research operations within the academic... medical center. This role ensures the highest standards of patient care, regulatory compliance, and staff supervision. The...