Jobs: medpoint management

Job DescriptionJob DescriptionSummaryMedPOINT Management is committed to conducting its business and operations in accordance with the highest legal and ethical standards. Our Code of Conduct sets forth our expectations of management, employees, and contractors to act in accordance with applicable laws and Company policy. MedPOINT’s Compliance Department...

Job DescriptionJob Description Summary MedPOINT Management is committed to conducting its business and operations following the highest legal and ethical standards. Our Code of Conduct sets forth our expectations of management, employees, and contractors to act under applicable laws and Company policy. MedPOINT’s Compliance Department ensures our culture...

Job DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...

Job DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...

Job Description Job Description Summary Under the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...

Job DescriptionJob Description MedPOINT ManagementTitle: Inpatient Nurse - Delegated Plans =====================================================================================MedPOINT, a large MSO in the San Fernando Valley offers competitive salaries and benefits in a collaborative working environment. For immediate consideration of this position, please...

Job DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) – Network Management Supervisor, the In-House IPA Representative serves as the liaison between the IPA clients, IPA client’s contracted providers and health plan(s). They will be responsible for the executing the provider onboarding, update, and...

Job DescriptionJob DescriptionThe Quality Management department is seeking a HEDIS/STARs Specialist to assist with clinic engagement in quality performance and patient experience programs. This is a position that may include field work to train staff and providers as well as performing chart abstracts. Duties and Responsibilities:1. Assume primary...

Job DescriptionJob Description SummaryUnder the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profiles in the...

Job DescriptionJob Description MedPOINT Management (MPM)Department: Utilization Management (UM)Title Associate Medical Director SummaryThe Associate Medical Director is responsible for providing medical interpretation and decisions about appropriateness of services provided by other healthcare professionals in compliance with Utilization Management...

Job DescriptionJob Description MedPOINT Management (MPM)Department: Utilization Management (UM)Title Associate Medical Director SummaryThe Associate Medical Director is responsible for providing medical interpretation and decisions about appropriateness of services provided by other healthcare professionals in compliance with Utilization Management...

**Summary**: Responsible for accurate review and input of claims in accordance with outside regulation, internal production standards and contractual obligations of the organization. **Duties and Responsibilities**: - Accurately review all incoming claims to verify if required fields are populated. - Process claims information into the computerized claims...

Job DescriptionJob Description    The Quality Management department is seeking a HEDIS/STARs Specialist to assist with clinic engagement in quality performance and patient experience programs. This is a position that may include field work to train staff and providers as well as performing chart abstracts. Duties and Responsibilities:1. Assume primary...

Job DescriptionJob DescriptionThe claims examiner is responsible for the adjudication of claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the Hospital Client. Researches, reviews and contacts provider services for problem claims and issues, as needed. Suggests process improvements to management and is...

Job DescriptionJob DescriptionSummaryThe claims adjuster is responsible for the adjusting of claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the IPAs. Researches, reviews and contacts provider services for problem claims and issues, as needed. Suggests process improvements to management and is a...

Job DescriptionJob Description SummaryUnder the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profiles in the...

Job DescriptionJob DescriptionThe Senior Software Engineer is responsible for designing, developing, analyzing, and managing the data infrastructure needed to support Business Intelligence and Reporting at MedPOINT Management. This position will be involved in all aspects of the software development life cycle. This individual will work closely with Software...

Job Description Job Description Under the general direction of the UM Delegation Specialist, the UM Delegation Coordinator is responsible for preparing, coordinating, and collaborating with UM and MPM departmental teams to facilitate delegated activities i.e. audit documents, regulatory reporting, and regulatory committee meetings. The UM DO Coordinator must...

Job DescriptionJob DescriptionSummaryUnder the general direction of Provider Network Operations (PNO) Project Manager, the Provider Directory Assurance Analyst is responsible for ensuring accurate, timely, and efficient reporting of Client IPA provider network data to the Health Plans, State or Federal entities. This position's primary functions are managing...

Job DescriptionJob DescriptionSummaryUnder the general direction of Provider Network Operations (PNO) Project Manager, the Directory Data Assurance Analyst is responsible for ensuring accurate, timely, and efficient reporting of Client IPA provider network data to the Health Plans, State or Federal entities. This position's primary functions are managing...