Must be able to: Ensure medically appropriate, high-quality, cost-effective care through assessing the medical necessity of inpatient admissions and extensions. Partner with physician clinical reviewers and/or medical directors to interpret appropriateness of care.
Assist management in preparing for health plan and SOC1 audits. Skills and Requirements Include: 10% travel. Expert knowledge of NCQA guidelines. Minimum 3-5 years relevant credentialing experience in a managed care setting. Proficiency in computer and software programs.
Ability to work from home with high speed internet access. Licensed Registered Nurse or Social Worker in the State of WV. 3-5 years of experience in Acute or Managed Care setting. Knowledge of medical terminology. Other requirements as outlined in the job description.
A behavioral health company is seeking a Telecommute Provider Relations Associate Vice President. Individual must be able to fulfill the following responsibilities: Overseeing coordination of practitioner and facility orientation and training.
Attends bid defense meetings. 3+ years of experience writing pharmaceutical or health-related documents. Licensed physician. Significant clinical trial experience. Clinical practice and/or clinical research or drug safety experience. Experience using computerized systems.
Provide support to physician staff, to ensure they are able to deliver stellar patient care. Identify and escalate priority issues that need immediate attention. Position Requirements Include: 3 years of experience in a customer service related role.
Must come to the Care Center for meetings and training. Have strong communication skills. A thirst for knowledge about our brands. Passion for the retail industry. Desktop computer or laptop with high speed internet & web camera. Must be comfortable using technology.
At least 6 years of experience working in homelessness, behavioral health and/or public health and/or other collateral systems. Bachelor's degree. At least 5 years of project management experience including supervising staff and administering budgets with excellent organizational skills.
A healthcare business has an open position for a Telecommute Licensed Telesales Agent. Core Responsibilities Include: Answering incoming phone calls from customers/members. Assisting customers/members in selecting a product that best meets their needs.
A health insurance company needs applicants for an opening for a Telecommute Client Member Specialist. Core Responsibilities of this position include: Empower ingmembers to make informed decisions. Evaluating the most appropriate type of provider for members' unique needs.