Job Description Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated
Job Description Job Summary: Provides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member
Come for the Challenge. Stay for the Experience. At HCVT, we believe every challenge presents an opportunity to positively impact our clients and people. Talented and ambitious individuals who seek limitless professional opportunities thrive at HCVT.
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 -
Medical Economics Manager Manages team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Collaborates with health plans identify and track
Job Title Leads and manages 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
Job Title Investigative Support for Special Investigation Unit (SIU) Activities Job Summary Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related
Pharmacy Technician Molina Healthcare is hiring for remote Certified Pharmacy Technicians. These roles will be in our Prior Authorization department. You will review prior auth requests that are submitted. Shift times for these roles will be Monday
Job Title Provides lead level clinical support to healthcare services team supporting one or more of the following functions: care management, utilization management, care transitions, long-term services and supports (LTSS), behavioral health, and other clinical programs, and