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Molina Healthcare
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Georgetown, Kentucky
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reviews and provides feedback to management, providers, and office staff
Provides training and ... planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
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Molina Healthcare
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Georgetown, Kentucky
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submitted by providers and the annual HEDIS medical record review. The Senior Specialist will be asked to ... /SKILLS/ABILITIES**
The Senior Specialist, Quality Improvement (Registered Nurse) contributes to
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Molina Healthcare
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Georgetown, Kentucky
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resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries ... , responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing
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Molina Healthcare
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Georgetown, Kentucky
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resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries ... , responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing
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Molina Healthcare
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Georgetown, Kentucky
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customers as it pertains to other provider network management areas, such as provider contracts ... Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry
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Molina Healthcare
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Georgetown, Kentucky
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Contracts.
• Develops and maintains provider contracts in contract management software ... positively impact the Medical Care Ratio (MCR) within each region.
• Advises Network Provider Contract
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