- Evolent (Phoenix, AZ)
- …and write clearly. + Reviews adverse determinations against criteria and medical policies + Creates adverse determination notifications that meet all accreditation, ... + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately identifies potential cases… more
- Sunrise Senior Living (Scottsdale, AZ)
- …+ Maintains communications with resident's family and or responsible party to ensure medical needs for the resident are being met. + Contacts resident's attending ... files according to Sunrise policies and federal and state regulations. + Maintains medical supplies and emergency kits for the community. + Provides clinical support… more
- Centene Corporation (Phoenix, AZ)
- …with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related to clinical initiatives ... providers. + Perform quality on site reviews of delegated entities, physician office /clinics, resolve quality issues, generate written summary of findings and follow… more
- Cardinal Health (Phoenix, AZ)
- …experience in related field preferred + Previous social work experience is preferred + LVN is preferred + 2-4 years of Case Management experience is preferred + ... B, C, D) + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred...Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook, and… more
Recent Jobs
-
Director of Sales and Marketing
- United Methodist Communities (Newton, NJ)