- Covenant Health (Nashua, NH)
- …established UM processes for patients not meeting criteria by utilizing second level review / Physician Advisor services. + Identifies opportunities for ... attended /documented. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices.… more
- Cardinal Health (Boston, MA)
- …This role's primary focus is to work diligently to ensure optimal reimbursement for physician services and physician satisfaction as it relates to managed care ... to the Managed Care environment. They will be a seasoned leader and advisor , with proven experience supporting physicians in oncology to identify and realize payer… more
- AmeriHealth Caritas (Manchester, NH)
- …and contractual requirements. At the request of BHM, this position will provide local physician review of SUD and BH treatment requests. The Med. Dir. SUD/BH ... will make recommendations regarding ACNH utilization management programs based on member and provider needs...need. + As requested by BHM, participate in the review of denials of care for SUD and BH… more