, medical necessity, coding accuracy and medical policy compliance.. Your Work In this role, you will: Assist... Director (MD) for MD collaboration and medical necessity determination Communicates determinations to members and providers in...
Nurse, Senior will report to the Manager, Utilization and Medical Review. In this role you will be performing first level... for medical necessity, coding accuracy and medical policy compliance. Clinical judgment and detailed knowledge of benefit plans...
of cases for medical necessity, coding accuracy, medical policy compliance and contract compliance Provides SME and support... for members with urgent needs Prepare and present cases to Medical Director (MD) for medical director oversight and necessity...
, and payment policy to accelerate the emergence of a value-based health care system in California. The Senior Medical Director..., Medical Policy will report to the Vice President of Medical Management. In this role you will be accountable for working in...
, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Senior Medical... Director, Medical Policy will report to the Vice President of Medical Management. In this role you will be accountable...
, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Senior Medical... concurrent review, pre and post service utilization review, and collaboration with RN Care Managers. The Senior Medical Director...
California. The Senior Medical Director, Behavioral Health will report to the Vice President, Medical Management. In this role... edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in...
, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical Director, Behavioral... Health will report to the Senior Medical Director, Behavioral Health. In this role you will have core responsibilities in the...
Director, Behavioral Health will report to the Senior Medical Director, Behavioral Health. In this role you will have core..., medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical...
our hospitals and out in the community. Responsibilities Job Summary / Purpose This Senior Counsel role serves as Legal... relating to health care operational issues, including patient consent, bioethics, risk management, medical staff, licensing...
for benefits, medical necessity, coding accuracy and medical policy compliance. In this role you will also perform Clinical... clinical case reviews to the Medical Director (MD) for MD collaboration and medical necessity determination Communicates...
Medicare member appeals for benefits, medical necessity, coding accuracy and medical policy compliance. In this role... and submits clinical case reviews to the Medical Director (MD) for MD collaboration and medical necessity determination...
for benefits, medical necessity, coding accuracy and medical policy compliance.. Your Work In this role, you will: Assist... Director (MD) for MD collaboration and medical necessity determination Communicates determinations to members and providers in...
Utilization Management Nurse, Senior will report to the Manager, Utilization and Medical Review. In this role... candidate reviews prior auth requests for medical necessity, coding accuracy and medical policy compliance. Clinical judgment...
of cases for medical necessity, coding accuracy, medical policy compliance and contract compliance Provides SME and support... for members with urgent needs Prepare and present cases to Medical Director (MD) for medical director oversight and necessity...
, coding accuracy, medical policy compliance and contract compliance Ensure discharge (DC) planning at levels of care... Director (MD) for medical director oversight and necessity determination and communicate determinations to providers...
, coding accuracy, medical policy compliance and contract compliance Ensure discharge (DC) planning at levels of care... Director (MD) for medical director oversight and necessity determination and communicate determinations to providers...