Essential Duties and Responsibilities: - Lead and execute sensitive, high-risk investigations (e.g., harassment, discrimination, retaliation, serious misconduct), including matters involving senior leaders and significant organizational risk; gather evidence, conduct interviews, assess credibility, and document findings. - Advise
Essential Duties and Responsibilities: - Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations. - Render determinations for cases assigned. - Resolve all other technical issues within reconsideration assigned. - Review cases
Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within