…in Performing utilization reviewsPreferred Other Experience performing UM in a managed care settingCandidate Skills:Intermediate Ability to communicate and make

…claims payment process, medical terminology and coding, case management practices, managed care , and Medicaid programs.Familiarity of National Committee on

…provide quality assurance oversight of all aspects of Behavioral Health programs including Managed Care and Medi-Cal Specialty Mental Health services, as well as

…such as a federal or state agency, institution, hospital, academic health science center, or managed care organization. 6. At least 2 years of which must have

Director, Grievance and AppealsLeadership opportunity within a growing managed care organization. Requirements:7 years’ experience in healthcare claims review

…and update insurance companies on admissions, discharges and changes in condition for managed care residents Attend and participate in weekly Medicare meetings

…years of related and pharmaceutical industry experience preferredExperience working with managed care organizations and health economics training preferredStrong

…support for pharmacy, DM programs, quality and UM. Exposure to managed care preferredLicenses/Certifications: Licensed pharmacist in state of operationSpecial

…Experience working within community-based home health organizations Experience working within a managed care environment Knowledge of community long-term care

…a rotating block schedule 16-bed adult mixed medical/surgical ICU with a hospitalist managed stepdown unit We care for general surgery, trauma, cardiovascular