About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review... Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide. We are currently seeking Board...
Evidence-Based Medical Review Conduct independent medical evaluations and/or chart reviews in alignment with state regulations..., MMRO standards, and clinical best practices. Review medical records, diagnostic data, and treatment histories to render...
working at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization... a Plus + Preferred Qualifications: -Health plan/payor Utilization Management / Review experience. -Electronic medical systems/record...
Anticipated End Date: 2026-02-27 Position Title: Plan Performance Medical Director- Kentucky and Missouri Markets... Job Description: Plan Performance Medical Director- Kentucky and Missouri Markets Location: This role requires associates to be in-office...
: Job Description Summary: UofL Health is a fully integrated regional academic health system with five hospitals, four medical centers, nearly.... Job Description: We are seeking a primary care physician to act as Medical Director and provide guidance and direction to Senior CommUnity Care...
, and other applicable laws and spend is effectively managed. Evaluates and improves opportunities to implement best practices at the... stakeholders, and suppliers. Leads the refining supply chain organization to ensure the refinery benefits from commercially...
review. How you will make an impact: Managing incoming calls or incoming post services claims work. Determines contract..., and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification...
: 3 days in the office, 2 days remote Excellent Benefits: Medical, Dental, Vision, Retirement, Vacation, Life Insurance... models to provide timely and accurate forecasting for assigned Cost of Good items (COGS). Review and revise all cost...
experience in matrix management organization Equipment and Systems Management: Check malfunctioning equipment and ascertain...: Complete annual onsite inspections once per year for approximately 65-80 sites managed under portfolio requiring manager...
experience in matrix management organization Equipment and Systems Management: Check malfunctioning equipment and ascertain...: Complete annual onsite inspections once per year for approximately 65-80 sites managed under portfolio requiring manager...
Plan, including construction execution, quality assurance, safety & health, subcontracting, staffing, organization chart..., bidder evaluation, and selection. Review, approve, and communicate internal and external reports including budgeting, cash...
. · A positive influence/champion within the team/organization. · Proactively seeks ways to improve things. Manages Territory... Field Service Manager to review work, receive direction and discuss customers' concerns and problems. · Requires daily...
. · A positive influence/champion within the team/organization. · Proactively seeks ways to improve things. Manages Territory... Field Service Manager to review work, receive direction and discuss customers' concerns and problems. · Requires daily...
Remote Prior Authorization Pharmacist – Work From Home in Managed Care A confidential managed care organization... to transition out of retail or hospital settings while building expertise in managed care. Key Responsibilities Review prior...
Appeals Pharmacist – Ensure Fair Medication Access for Patients A confidential managed care organization is seeking... an experienced Appeals Pharmacist to review, evaluate, and process medication coverage appeals. This role is ideal for pharmacists...
Remote Prior Authorization Pharmacist – Work From Home in Managed Care A confidential managed care organization... to transition out of retail or hospital settings while building expertise in managed care. Key Responsibilities Review prior...
Appeals Pharmacist – Ensure Fair Medication Access for Patients A confidential managed care organization is seeking... an experienced Appeals Pharmacist to review, evaluate, and process medication coverage appeals. This role is ideal for pharmacists...
initiation of activities necessary to comply with managed care contracts and CMS regulations. Position is responsible... process upon patient's arrival. Position is responsible for the review of past account balances, notifying patient...
care management or case management experience and requires a minimum of 2 years clinical, utilization review, or managed... American Association of Managed Care Nurses is preferred. Knowledge of the medical management processes and the ability...
from new and established customers, process requests for quotes, enter orders, managed from inception to completion... Review and interpret customer specifications, applications, and terms and conditions with assistance from Engineering...