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: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation from
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation from
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation from
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: - Supervise a team of employees through cultivation of a high performance team - Ensure adequate staff coverage for assigned program area - Serve as subject matter expert for identified area of
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
- Train, mentor and coach less tenured change management analysts. - Partner with product management team to see changes through implementation. - Partner with project management team to see changes through implementation. - Communicate directly with
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation from
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation from
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: - 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,
Job Description Essential Duties and Responsibilities: - Oversee and manage the Projects financial performance, including budgeting, forecasting, and analyzing profit and loss statements to ensure financial targets are met and profitability is maintained. - Ensure program
Essential Duties and Responsibilities: - Manage delivery of a defined program, ensuring achievement of schedule, cost, quality, compliance, and client satisfaction objectives. - Oversee day-to-day program execution, including planning, resource coordination, workload management, and monitoring progress