director who manages non-clinical workforce activity. Relationship Management & Communication: Ensure the team has established...Company : Highmark Health Job Description : JOB SUMMARY This role will support the leadership team for Clinical...
that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The... incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity...
that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The... incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity...
with provider relations and clinical transformation consultants to explain new programs and results to key provider partners... Familiarity with alternative care model designs (e.g., patient centered medical home, ACO), alternative reimbursement models (e.g...