…services. Works collaboratively and facilitates communication with physicians, family members, managed care providers and other multidisciplinary team members

…of the background check process. **Preferred Qualifications** + Knowledge and experience in managed care + Medical terminology + Experience in EMR (Electronic

…with prescription refill calls and patient call backs. + Assists with managed care referral process, pre-authorization, and pre-certification processes. +

…Knowledge of medical terminology, anatomy, disease processes, CPT and ICD-9 coding, and managed care policies and procedures. + Familiar with Windows software,

…Experience in Substance Use Disorder and Mental Health Disorder + Experience working with Managed Care services and agencies or hospital based experience a plus.

…and provider utilization patterns. + Conducts proactive outreach to support the understanding of managed care policies and procedures, as well as on a variety of

…**Minimum Requirements:** + Requires BA/BS in Pharmacy. + Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience;

…required. Qualifications: + Minimum of two (2) years previous experience in a managed care organization's Credentialing department. + NAMSS CPCS certification is

…claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with

…required documentation of interactions and as well as ongoing review and resolution of managed care . + Consults Clinical Manager if there are any clinical