Delivery Manager The Delivery Manager holds program-level execution accountability for an assigned portfolio and is responsible for the financial performance, operational execution, and strategic success of an assigned portfolio within the Business Unit. This role owns the
Essential Duties and Responsibilities: - Responsible for completing medical and/or behavioral health assessments within contract requirements - Conducts on-site, video call and/or telephonic assessments to determine an individuals needs for services and supports, eligibility, level of
Essential Duties and Responsibilities: - Answer general inbound calls and place outbound calls with the goal of increasing business, customer satisfaction, and customer retention. - Follow basic procedures and scripts, using fundamental knowledge of company and
Essential Duties and Responsibilities: - Collaborate with project staff, client office personnel, and community agencies to address and resolve project-related issues effectively. - Deliver public speaking sessions and educational programs to community agencies and local office staff.
Essential Duties and Responsibilities: - Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments. - Provide written clinical rationales for CA Workers Compensation
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 Medicare
Essential Duties and Responsibilities: - Research and resolve discrepancies with provider documents. - Review information keyed into the system to verify the accuracy of data. - Monitor data/image quality of scanned documents. - Follow established policies