Job Title Provides 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 behavior change through actionable data and
Essential Duties and Responsibilities: - Serve as the subject matter expert on U.S. immigration laws, regulations, policies, and procedures; provide authoritative guidance and regulatory interpretation to program teams, leadership, managers, and employees. - Monitor, analyze, and
Essential Duties and Responsibilities: - Build and maintain knowledge base in SharePoint. - Build document management processes and procedures. - Assess knowledge base needs, inaccuracies, gaps; work quickly to resolve and make content current. - Work cross-functionally
Essential Duties and Responsibilities: - Review requests for services, including admissions, discharges, and continued stays for adherence to clinical criteria, state and federal policy, and contract requirements involving broad clinical complexity and variability; apply subject matter