Scan your resume against ATS criteria for this Pricing Manager role at Fa Ewjt Saasfaprod1.
Works with Regional Medical Directors to make sound, evidence based clinical decisions regarding the requested cases (treatments and procedures) for IP/OP and performs retrospective clinical reviews utilizing criteria set forth by the client and Medicare (CMS-Centers for Medicare and Medicaid Services) and perform outbound calls to providers.
Performs clinical review of cases received from the specialist team or other departments within CCR, determines if additional clinical information if required, makes a clinical decision to approve or deny a case based on plan coverage, criteria and / or guidelines or pend / refer it to the Regional Medical Directors for further review for medical necessity, and coordinates a peer to peer (doctor to doctor case discussion) review as applicable.
Bachelor Degree in relevant field with 6- 8 years of relevant experience
Medical Directors to make sound, evidence based clinical decisions regarding the requested cases (treatments and procedures) for IP/OP and performs retrospective clinical reviews utilizing criteria set forth by the client and Medicare (CMS-Centers for Medicare and Medicaid Services) and perform outbound calls to providers.
How to apply for Pricing Manager at Fa Ewjt Saasfaprod1?
Click the "Apply on Company Website" button on this page to submit your application directly on the employer's official portal.
What is the salary for this role?
Salary details will be discussed during the interview.
What experience is required?
6-8 years of experience is required.
Is this position still open?
Yes, currently active and accepting applications.
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