Position Purpose. . Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication. . Responsibilities. Responsible for conducting provider orientations of newly contracted providers within the specified time frames as indicated in Policy & Procedure PR – 01. Responsible for securing a signed Notice of Educational In - Service Acknowledgement Form upon completion of each...
Position Purpose. . Exercise the duties and responsibilities delegated to the Provider Relations Representative with the outmost professionalism and dedication. . Responsibilities. Responsible for conducting provider orientations of newly contracted providers within the specified time frames as indicated in Policy & Procedure PR – 01. Responsible for securing a signed Notice of Educational In - Service Acknowledgement Form upon completion of each...
To support the Director of Member Services in providing a single point of contact for questions, problem solving, and access to care, for all involved in members’ care. To provide accurate, prompt, and courteous service in response to written and telephonic inquiries, from Members, Members’ Care-Givers, Primary or Interdisciplinary Care Team Members, Pharmacies, and Vendors. To facilitate quality member care and service delivery by responding to...
Job Description. Job Description. This position will require attendance in our office in Coral Gables, FL. Position Purpose. The HEDIS Manager oversees all aspects of Healthcare Effectiveness Data and Information Set (HEDIS) operations at Doctors HealthCare Plans (DHCP), including strategic planning, data collection, quality control, reporting, and analysis. This role ensures compliance with the National Committee for Quality Assurance (NCQA), re...
Job Description. Job Description. This position will require attendance in our office in Coral Gables, FL. Position Purpose. The HEDIS Manager oversees all aspects of Healthcare Effectiveness Data and Information Set (HEDIS) operations at Doctors HealthCare Plans (DHCP), including strategic planning, data collection, quality control, reporting, and analysis. This role ensures compliance with the National Committee for Quality Assurance (NCQA), re...
Roles and Responsibilities. Demonstrate effective communication and problem-solving skills. Assist Accounting Manager with the day-to-day, monthly and year-end operations of the Accounting/Finance department. Prepare and post monthly Journal Entries to the GL. Prepare and analyze monthly financial statements. Perform general accounts analysis and reconciliations, including bank statements, fixed assets, accruals and prepaid expenses. Assist with ...
Roles and Responsibilities. Demonstrate effective communication and problem-solving skills. Assist Accounting Manager with the day-to-day, monthly and year-end operations of the Accounting/Finance department. Prepare and post monthly Journal Entries to the GL. Prepare and analyze monthly financial statements. Perform general accounts analysis and reconciliations, including bank statements, fixed assets, accruals and prepaid expenses. Assist with ...
Position is On-Site. Scope of Position. Maintain an efficient provider credentials system by ensuring completed credentials CAQH profiles and/or applications are received and processed, correct data entry, and updated regulatory and credentialing documents are entered and/or scanned into the Doctors HealthCare Plans, Inc, (“DHCP”) credentialing CACTUS database, provide data entry and clerical support to the Credentialing Department. This positio...
Position is On-Site. Scope of Position. Maintain an efficient provider credentials system by ensuring completed credentials CAQH profiles and/or applications are received and processed, correct data entry, and updated regulatory and credentialing documents are entered and/or scanned into the Doctors HealthCare Plans, Inc, (“DHCP”) credentialing CACTUS database, provide data entry and clerical support to the Credentialing Department. This positio...
Position Purpose. The. Receptionist. is responsible for performing clerical tasks within an office setting to support daily operations. Responsibilities. Answer and transfer phone calls in professional manner. Sort and deliver mail to employees. Greet visitors upon arrival and coordinate meetings with management or staff, as well as direct and announce them appropriately. Maintain office security by following safety procedures and controlling acc...
Position Is Not Remote. Position Purposes. Evaluates and approves requested services using organizational policies or MCG® screening criteria. Responsibilities. Manages appropriate cases that require medical necessity review such as home care, elective inpatient and outpatient service requests. Reviews cases referred by the prior-authorization non-clinical medical management coordinator and pre-certification technician staff according to member b...
