About Pair Team At Pair Team, were an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social -
Job Title Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach
Job Title Provides support for member clinical service review processes specific to behavioral health. Job Description Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary
Job Title Provides lead level support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching
Job Title Job Summary Will require to be infield twice a week subject to change Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary