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: - Supervise the work of call center staff to ensure adherence to quality standards, deadlines, and proper procedures, correcting errors or problems as needed - Interview and recommend hiring and promotion of
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: - 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: - Works on assignments that are semi-routine in nature but recognizes the need for occasional deviation from accepted practice. - Follow procedures and directions to assess the quality of service provided through
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: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
Essential Duties and Responsibilities: - Generate and implement efficient sourcing and category management strategies through the RFx process. - Develop and negotiate contracts with new suppliers and/or renegotiate existing contracts to accomplish the lowest total system
Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
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 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
Essential Duties and Responsibilities: - Supervise a designated team of unit staff - Responsible for the training and development of unit staff - Monitor the activities, schedules, productivity and work product results of the assigned unit
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