Essential Duties and Responsibilities - Assist leadership with the day-to-day running of the core functional areas to ensure compliance with the prime contract, all subsequent amendments, program business rules, as well as state and federal regulations
Essential Duties and Responsibilities: - Facilitate the development of cross-line-of-business solutions by combining knowledge of business capabilities, value streams, and business processes. Consult with technical subject matter experts to develop technical solutions and advise on options,
Key Responsibilities 1. Jointly monitor operational and clinical performance across PIP & WCA with support from Head of Assurance & Audit using site and individual MI to spot trends, risks and development needs; create and execute
Essential Duties and Responsibilities: - Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. - Issue approvals, denials or recommendations based on contract
Essential Duties and Responsibilities: - Responsible for database administration, data consolidation, data analysis and management reporting. - Design database reports based on the requestors requirements in support of key business strategies. - Perform queries, data extraction, manipulation, and analysis to provide
Essential Duties and Responsibilities: - Assess and evaluate staff performance based on established goals and standards. - Identify and develop areas of opportunity for direct reports. - Manage QC supervisors performance management and tracking methods. -
Essential Duties and Responsibilities: - Provide feedback regarding the design, development and distribution of training programs and materials as needed. - Conduct, plan, and coordinate training to a variety of audiences. - Coordinate logistics for instruction
Essential Duties and Responsibilities: - Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data. - Enter coded data into a system accurately and
Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organizations coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct
Essential Duties and Responsibilities: - Supervise the workforce management team and workflow to support management in all aspects of the workforce function within the project. - Create and maintain workforce monitoring schedules for team members to