Description. Summary/Position Objectives. This position reports to the Provider Data Management Supervisor and is responsible for assisting and supporting the Provider Management division in its daily operations and planning specifically the administration of provider services to Maryland Physicians Care, a managed care organization. The incumbent will provide the team with high-level, detail-oriented administrative support to include document in...
Description. Hybrid position with variable hours. 9-6, 10-7 with 3 days a week onsite. Summary. Under indirect supervision, this CHW works closely with medical providers, primary care teams, and social services agencies to provide short-term care coordination and connection to resources and support to program members to improve their health and general well-being through education and coordination of care and services. Works in. both clinical and...
Description. Summary/Position Objectives. Under limited supervision, this position is responsible for developing and maintaining an anti-fraud program which includes the development and delivery of training and filing of fraud plans and reports. This position is responsible for conducting reviews of the organizational or functional activities related to alleged fraud, waste and abuse perpetrated by providers, members, facilities, pharmacies, grou...
Description. Summary/Position Objectives. Under the direction of the Senior Medical Director, the Medical Director will lead and participate in the Maryland Physicians Care MCO’s (MPCMCO) Medical Management Program. The Medical Director will assist in the development and implementation of comprehensive medical policies and standards of care. The Medical Director will provide leadership for the Health Management Teams. The Medical Director is resp...
