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CINCINNATI, Ohio
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and Wisconsin. Our group plans include a variety of group medical, pharmacy, dental, vision, life and
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Cincinnati, Ohio
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Provider Contract/Cost of Care Consultant Senior-Analytics
Location: This ... looking for a senior analyst who will lead medical cost trend deep dives to uncover root-cause trend
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Cincinnati, Ohio
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Group Underwriter Consultant, Sr
Location: Open to any Pulse Point location ... .
The Group Underwriter Consultant, Sr is responsible for determining acceptability of
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CINCINNATI, Ohio
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** is responsible for the review of medical records to determine if requests for therapy services ... additional data, consults with clinical reviewers and medical directors, when necessary.
Acts as a
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CINCINNATI, Ohio
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order, facility protocols, INS standards and company policy and procedures.
Completes admission ... physical assessment as needed.
Documents all pertinent data in the patient’s medical record
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Cincinnati, Ohio
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Clinical Operations Associate Medical Director
Neurosurgery
Carelon Insights/Carelon Medical Benefits Management
_A proud member of the Elevance Health family of
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CINCINNATI, Ohio
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companies. We are a third-party administrator (TPA) of medical benefits, also providing medical management
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Cincinnati, Ohio
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treatment setting by utilizing the applicable medical policy and industry standards accurately interpreting ... appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and
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CINCINNATI, Ohio
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process on such issues as administrative and medical policy, reimbursement, and provider utilization
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Cincinnati, Ohio
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Stop Loss Group Underwriter Consultant, Sr
Location: Open to any open-access ... Stop Loss Group Underwriter Consultant, Sr is responsible for determining acceptability
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CINCINNATI, Ohio
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HEDIS Business Information Consultant
Location: This position will take part in ... Business Information Consultant** is responsible for serving as an expert in data analysis, reporting
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CINCINNATI, Ohio
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Underwriting Consultant Sr.** is responsible for determining acceptability of insurance risks and ... experience, location, demographics, etc.
Determines and provides guidance to medical underwriters
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Cincinnati, Ohio
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analytics.
Medical Director-Internal Medicine
Responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective
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