Career Opportunities

JOB SUMMARY Responsible for reviewing prior authorization requests for medical services including elective admissions (Post-Acute and Acute), inpatient surgeries, outpatient surgeries, home health, and durable medical equipment. RN will prioritize expedited requests for medical necessity and efficiency in accordance with health plan coverage guidelines and CMS coverage determinations…

JOB SUMMARY The Contracting & Credentialing Specialist initiates, negotiates, and executes Medicare Advantage (MA) physician, hospital, and/or other provider contracts and agreements. The Contracting & Credentialing Specialist also obtains, reviews, and processes physician, facility, and ancillary initial & re-credentialing applications and supporting documentation to approve credentialing and…