Overview Leads the clinical audit team and oversees quality improvement initiatives with a primary focus on Medicare... oversight. This role will be the primary clinical point of contact for STARS and quality initiatives while supporting strategic...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care...
opportunities for improvement relating to quality and cost while maintaining adherence to compliance and nursing standards of care... Behavioral Health program. Acts as a key resource in providing clinical and operational guidance and support to assigned teams...
's pharmaceutical programs across all business lines. Resolves problems regarding Pharmacy Benefit Manager (PBM) clinical pharmaceutical... to identify areas for improvement and implement quality initiatives Collaborates with internal and external healthcare teams...