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Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
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Analyzes patient data and satisfaction surveys for reimbursement, facility planning, and quality of patient care, risk management and utilization management; based on this analysis, the RDOs along with the Clinical and Nutritional Services Directors, will implement policies and procedures to improve quality of care and satisfaction.
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Unless expressly allowed by state or federal law or regulation a must be located in a state or territory of the United States when conducting a utilization review or an appeals consideration and cannot be located on a US military base, vessel, or any embassy located in or outside of the US.
$342,936 a yearFull-timeExpandApply NowActive JobUpdated 29 days ago - UpvoteDownvoteShare Job
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Utilization management experience in a medical management review organization, such as Medicare Advantage and managed Medicaid. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type.
$274,400 a yearFull-timeExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Sr. Director, Regional Operations is responsible for practices profit & loss by partnering with OMs and STs to manage patient schedule utilization, staff productivity, collections, receivables, and controlling operations expenses.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Demonstrated expertise in managed care services such as Network Utilization, Case Management, Bill Review and Pharmacy Benefit Management. Resolve service issues through appropriate channels; Essential elevate operations issues to Local Management Team or Regional Vice President as appropriate.
$132,692 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago
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