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Description The Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
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... antigen receptor T cell (CAR-T) therapy services Guide members by providing information ... design and identify potentially unnecessary services and care delivery settings and ... in the fast-paced industry..
Description The Care Management Support Assistant 2 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
... Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided under the Exceptional ... and authorizations. Coordinate and approve services for ABA Therapy. Review outcome measures to ensure..
Description Responsibilities The ACD Referral Authorization Coordinator Lead role will assist the Supervisor in oversight & monitoring of processing and timeliness standards for referrals and authorizations under the Autism Care Demonstration ..
... expertise within the realm of Healthcare Quality operations and improvement methodology, ... a subject matter expert in healthcare quality measurement, best practices, and ... Assurance (NCQA), the Agency for..
Description The Staff Clinical Pharmacist manages the formulary processes for the Clinical Formulary Administration team for the Medicaid LOB. The Staff Clinical Pharmacist work assignments involve moderately complex to complex issues ..