- Centene Corporation (New York, NY)
- …evidence of expected clinical performance within contractual and Model of Care standards. + Conducts clinical file assessments by reviewing clinical documentation ... Participates as needed with preparation for State, CMS, and NCQA audits by collecting and /or reviewing clinical areas...(inpatient or outpatient). 1+ year of experience in Managed Care (UM, BH, CM) preferred. Familiarity with Medicare and… more