by Advize Admin | Sep 2, 2022
Summary This job manages a team of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures adherence to medical policy and member benefits in providing service that is medically...
by Advize Admin | Sep 2, 2022
Summary This job is responsible for serving as a liaison between the member, the Health Plan, and the provider for the plan’s Medicaid product. The position conducts telephonic support to assess member needs, provide appointment scheduling assistance, and...
by Advize Admin | Sep 2, 2022
Summary This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate resource utilization, identification of opportunities for referral to a Health...
by Advize Admin | Sep 2, 2022
Summary This job manages a team of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures that care is medically appropriate, high quality, and cost effective. The incumbent is...
by Advize Admin | Sep 2, 2022
Summary This job assures that members with complex medical and/or psychosocial needs have access to high quality, cost-effective health care. Assists in the holistic assessment, planning, arranging, coordinating, monitoring, evaluation of outcomes and activities...
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