- Highmark Health (Jefferson City, MO)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Highmark Health (Jefferson City, MO)
- …conceptualize and design how people interact with finding and accessing virtual/physical medical and behavioral care in tight collaboration with our Experience, ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Pearl Interactive Network (Jefferson City, MO)
- …similar agencies. + Proven track record of operational success within Call Center, Behavioral Health , or IT Support environments. + Expertise in establishing and ... **Pearl Interactive Network is sourcing a Project Control Director .** The **Project Control Director (PCD)**...Salary Range: $90K - $140K+ (commensurate with experience) + Medical , Dental, Vision, and Life Insurance + Paid time… more
- Evolent Health (Jefferson City, MO)
- …as required. + Entering data into a proprietary system generates cases for both the medical and behavioral health reviewers. These requests may be submitted ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...will serve as a point of contact for processing medical treatment requests in accordance with departmental policies, regulatory… more