Job Summary: The Associate Vice President, Provider Contracting, Network and Relations informs decision-making around payer and provider best practices related to innovating, supporting and empowering providers in the pursuit of delivering person-centered and high-quality care to
Job Summary: The Claims Specialist III is responsible for capturing, resolving/facilitating resolution, and reporting on claim adjustment requests. Essential Functions: Resolve complex COB issues through member information updates and adjustment of claims Maintain accountability for daily
Job Summary: The Clinical Psychologist provides Behavioral Health coverage determination for utilization management to ensure members receive appropriate and medically necessary care in the most cost-effective setting. Essential Functions: Assume responsibility for the overall safety of
About Concept Plus Concept Plus is a mission-focused technology solutions provider that transforms IT concepts into impactful solutions for federal agencies. Headquartered in Fairfax, VA, we bring the agility, responsiveness, and customer intimacy of a small
Job Summary: The Enterprise Medical Director is responsible for the development, implementation and revision of corporate level clinical care standards and practice guidelines, ensuring compliance with nationally accepted quality standards. Essential Functions: Development, implementation and revision of the