- Northeast Alabama Regional Medical Center (Anniston, AL)
- …Paragon. Completes all data fields to ensure needed information is gathered. Performs medical record management functions. Answers telephone and routes calls to ... verification, PM&R billing, receptionist duties, answering phones, filing, payment management , and obtaining accurate referral information. This position requires… more
- Healthfirst (IA)
- … (CMS), New York State Department of Health (NYSDOH), or MLTCP regulations governing medical management in managed care + Work experience in managed care or ... maximize the quality of patient care while achieving effective medical cost management + Additional duties as...healthcare industry in utilization management including preauthorization of outpatient or inpatient … more
- Guthrie (Binghamton, NY)
- …Case Manager has the responsibility, accountability, and authority for coordinating the medical management of hospital patients, using outcomes based approaches. ... Director and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b)… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …Substance Abuse Policy for further information. Basic understanding of complex medical record management concepts, data integrity, health information standards ... Experience 2 + years' experience in related field (customer service , patient registration, scheduling, IT etc) preferred Physical: This...and regulations. Excellent customer service and interpersonal skills. Ability to maintain high level… more
- Centene Corporation (Olympia, WA)
- …changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national ... Chief Medical Officer to direct and coordinate the behavioral health medical management , quality improvement and credentialing functions for the business… more
- Humana (Charleston, WV)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
- Humana (Dover, DE)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
- Sharp HealthCare (San Diego, CA)
- …+ Works collaboratively with other plan functions that interface with medical management such as provider relations, member services , benefits and claims ... of physician's insight, perspective and leadership on the Health Services Management team and the other strategic..., etc. + Plans, organizes, and directs the professional medical services program, consisting of all primary… more
- Centene Corporation (Dover, DE)
- …changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national ... medical reviews for utilization management , including the assessment of medical necessity, service requests, and appeals, with a focus on clinical… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …input into the development of policies, programs and strategic objectives that cover Medical Management Services through their required participation in ... of the Medical Services area including, but not limited to, Medical and Pharmacy Utilization Management , quality management , member care … more