Job Title Job Description Job Summary Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes Uses a consultative approach emphasizing physician engagement and
Job Title Behavioral Health Clinical Reviewer Job Description Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical guidelines,
Job Title Investigative Support for Special Investigation Unit (SIU) Activities Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting for the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to
Member Engagement & Interventions Senior Specialist The Member Engagement & Interventions (MEI) Senior Specialist is responsible for managing, and executing member engagement programs that drive behavior change, improve health outcomes, and support overall plan performance. This role