Typically works with less complex providers which may include, but are not limited to, professional providers, practice groups, small medical groups, providers…
Prepares or completes various forms, reports, correspondence, case records, client activity reports, service plans, uniform assessment instrument, needs…
Serve external customers - oversee provider advisory councils and manage provider grievances/complaints. Experienced in managed care, health plan operations in…
Any potential denials require a clinical review by a pharmacist before a final denial is sent to the provider/member. Must be a CA licensed Pharmacist.
May assist with identifying and recruiting providers based on network composition and needs. The Provider Contracting Professional 2 communicates contract terms…
Manage patient and provider schedules for assigned area. The team coordinator manages workflow by coordinating and maintaining provider schedules, uses a…
ACES Quality Management provides the industry's leading software solution for quality control and audit. In fact, 33% of the top 150 lenders in the U.S. partner…
