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Summary of Job Perform clinical reviews within the Medical Management Operations Concurrent Review utilization management department. Ensure accurate....
EmblemHealth
Clinical
Summary of Job Responsible for the day-to-day operation and performance of the care management team providing care management services to...
EmblemHealth
Clinical
Summary of Job Provide active oversight and ongoing direction for the utilization management of Pharmacy vendors and quality assurance process...
EmblemHealth
Summary of Job Responsible for overseeing the day-to-day operations of the Grievance and Appeal Specialists, ensuring adherence to department...
EmblemHealth
Operations
Summary of Job Process disputes submitted by contracted and non-contracted providers. Types of correspondence handled by the individual will include,....
EmblemHealth
Operations
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