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Provides/gathers clinical expertise for areas of compliance which involve medical necessity and/or quality concerns. Utilizes clinical expertise to conduct investigations and seek input from other clinical professionals as required. Acts as a liaison, analytical person, and negotiator to achieve resolution on member requests, appeals and issues with contracted providers. Responsible for reviewing and analyzing audit related reports and providing consultation on non-compliance. Manages the planning, development, implementation/delivery, and evaluation/ improvement of rehabilitation therapy programs/services provided by extended care contracted providers.
Qualifications:
Other
Hospital
$109k-133k (estimate)
04/24/2024
06/23/2024
LOMITA, CA
>50,000
2007
THELMA NERI
$50M - $200M
Hospital