CISC Clinical Auditor

Gathers and synthesizes clinical information in order to authorize services. Reviews health care services to determine consistency with contract requirements, coverage policies and evidence-based medical necessity criteria. Collects and analyzes utilization information. Assists with program processes for transitions across levels of care including discharge...

Gathers and synthesizes clinical information in order to authorize services. Reviews health care services to determine consistency with contract requirements, coverage policies and evidence-based medical necessity criteria. Collects and analyzes utilization information. Assists with program processes for transitions across levels of care including discharge...

Supporting Care Coordinators with triaging transitions from higher to lower levels of care for in-state and out of state discharge planning using individual planning process. Works closely with CFYD permanency placement coordinators to establish appropriate transitions as recommended by the treatment team.Coordinates care of individual clients with...

Supporting Care Coordinators with triaging transitions from higher to lower levels of care for in-state and out of state discharge planning using individual planning process. Works closely with CFYD permanency placement coordinators to establish appropriate transitions as recommended by the treatment team.Coordinates care of individual clients with...

This position works collaboratively with child serving state agencies (e.g., Children, Youth, and Families Department) ensuring members receive care coordination and appropriate access to eligible and necessary services. Provides training and technical assistance to both internal and external stakeholders in order to enhance communication and coordination...

Responsible for the development, strategy, and implementation of community outreach programs in conjunction with the Clinical and Administrative departments. Leads the development of strategic plans for engagement, within assigned territories, regions or communities, that nurture and retain positive relationships between the health plan, members and...

Responsible for the development, strategy, and implementation of community outreach programs in conjunction with the Clinical and Administrative departments. Leads the development of strategic plans for engagement, within assigned territories, regions or communities, that nurture and retain positive relationships between the health plan, members and...

Must be a resident of NM. Conducts reviews of clinical interactions and clinical documentation including reviews of case management records. Provides clinical reviews of CISC files to ensure clinical team is addressing all contractual needs of the program in the appropriate assessments. Provides feedback to the clinical teams on contractual compliance and...

Must be a resident of NM. Conducts reviews of clinical interactions and clinical documentation including reviews of case management records. Provides clinical reviews of CISC files to ensure clinical team is addressing all contractual needs of the program in the appropriate assessments. Provides feedback to the clinical teams on contractual compliance and...

This position works collaboratively with child serving state agencies Children, Youth, and Families Department) ensuring members receive care coordination and appropriate access to eligible and necessary services. Provides training and technical assistance to both internal and external stakeholders in order to enhance communication and coordination within...

Job DescriptionJob DescriptionUnblinded Clinical Research Coordinator IDM Clinical Research is looking to hire an Unblinded Clinical Research Coordinator to join our team. This individual will be responsible for dispensing Investigational Products (IP) as part of clinical research trials.Duties & Responsibilities:Compound and dispense prescribed IP.    ...

Job DescriptionJob DescriptionUnblinded Clinical Research Coordinator IDM Clinical Research is looking to hire an Unblinded Clinical Research Coordinator to join our team. This individual will be responsible for dispensing Investigational Products (IP) as part of clinical research trials.Duties & Responsibilities:Compound and dispense prescribed IP.    ...

Job DescriptionJob DescriptionUnblinded Clinical Research Coordinator IDM Clinical Research is looking to hire an Unblinded Clinical Research Coordinator to join our team. This individual will be responsible for dispensing Investigational Products (IP) as part of clinical research trials.Duties & Responsibilities:Compound and dispense prescribed IP.    ...

Job DescriptionJob DescriptionUnblinded Clinical Research Coordinator IDM Clinical Research is looking to hire an Unblinded Clinical Research Coordinator to join our team. This individual will be responsible for dispensing Investigational Products (IP) as part of clinical research trials.Duties & Responsibilities:Compound and dispense prescribed IP.    ...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Remedy's mission is to help make prescription drugs more affordable and accessible for payors and patients for optimum health. Our analytics produce an "MRI" of a company's complex Rx spend, uncovering actionable...

This position has special interest in working with a broad range of mental health conditions in children with special emphasis on trauma spectrum disorders. Has solid knowledge and experience in working with the child welfare system. Is a subject matter expert in resources available to CISC children and youth in need of behavioral, physical and long-term...

Overview Now hiring a Utilization Management Nurse Specialist Performs clinical review to ensure that services rendered to members meet clinical criteria and are delivered in the appropriate setting. Utilizes clinical skills to to coordinate, document and communicate all aspects of the utilization/benefit management program. Performs care review both...