- State of Colorado (Jefferson County, CO)
- …disabilities living in Colorado. Admissions are for individuals with complex behavior and medical needs who may pose a risk to themselves or the community. We ... individuals who have profound and severe disabilities with a high level of medical needs, and/or have significant behavioral and psychiatric challenges. The focus of… more
- Cedars-Sinai (Beverly Hills, CA)
- …Express) no later than date of discharge. + Communicates regularly with CSMPN Medical Director , Employee Health Services, Risk Management, and TPA + Attends ... 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded...Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and… more
- Atlantic Health System (Morristown, NJ)
- …athletes, coaches, and medical staff as indicated 9. Manages and resolves complex grievances related to the medical care provided to athletes 10. Acts as ... AHS affiliated School or Team Organization to autonomously provide medical care to all athletes affiliated with designated School...highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its… more
- Tufts Medicine (Boston, MA)
- …clinical trial budgets with sponsors and assists with the completion of Medicare Coverage Analyses. 4. Keeps abreast of new and modified sponsor regulations ... of fiscal state of research program/laboratories and makes recommendations to PIs and director for planning purposes. 9. Meets regularly with director and PIs… more
- UCLA Health (Los Angeles, CA)
- …of Patient Rights & Responsibilities, Joint Commission standards, and Centers for Medicare / Medicaid regulations. Knowledge of Medical Terminology. Strong ... Serve as liaison for patient escalations in collaboration with the IDH Clinic Director . + Ensure compliance with UCLA processes and standardization of patient access… more
- Molina Healthcare (Cadillac, MI)
- …Tighter knit proximity ongoing after contract. * In conjunction with Director /Manager, Provider Contracts, negotiates Complex Provider contracts including but not ... software. * Targets and recruits additional providers to reduce member access grievances . * Engages targeted contracted providers in renegotiation of rates and/or… more