-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Cincinnati, US-OH
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:18
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Charlotte, US-NC
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:17
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Rochester, US-NY
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:16
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Albuquerque, US-NM
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:15
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Columbus, US-OH
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:15
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Cherry Hill, US-NJ
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:14
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Las Cruces, US-NM
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:13
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Manchester, US-NH
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:12
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Newark, US-NJ
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:12
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Albany, US-NY
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:11
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Lebanon, US-NH
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:10
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Buffalo, US-NY
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:09
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Reno, US-NV
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:09
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Billings, US-MT
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:08
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Missoula, US-MT
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:07
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: North Platte, US-NE
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:06
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Bozeman, US-MT
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:05
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Springfield, US-MO
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:05
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Omaha, US-NE
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:04
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Las Vegas, US-NV
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:03
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Jackson, US-MS
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:02
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:01
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Tupelo, US-MS
Salary / Rate: 21.75
Posted: 2024-04-17 08:48:00
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Minneapolis, US-MN
Salary / Rate: 21.75
Posted: 2024-04-17 08:47:59
-
Description & Requirements
Maximus is currently hiring a Sr.
Admin - Medical to support the Independent Medical Review (IMR) project.
Essential Duties and Responsibilities:
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned.
- Provide coverage rule review support to QIC project directors and medical directors, by continuously monitoring CMS and relevant contractor websites for coverage rule updates.
- Create and maintain standardized decision letter language consistent with CMS guidance for all QIC projects.
- Create and maintain internal database for Medicare coverage review policies.
- Create and maintain ISO compliant work instruction and process documents.
- Interface and coordinate activities between QIC project directors/medical directors and adjudication team, client and project end user (i.e.
health plans or health plan enrollees).
- May provide assistance to other department/operations as needed and directed by QIC lead.
- Generate reports as needed.
- Perform other duties as may be assigned
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with 4+ years of experience, or Associate degree with 2+ years' experience.
- May have additional training or education in area of specialization.
- Work on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understand implications of work and make recommendations for solutions.
- Communicate on complex or sensitive issues or draft such responses for supervisor or team lead.
- High School Diploma or equivalent
- 1 year of experience in a customer service role
- Strong analytical skills
- Detail and solution oriented
- Ability to work independently
- Excellent written and oral communication skills
- Proficiency in Microsoft Office suite,
Preferred Skills:
- Knowledge of medical terminology
- Experience with basic data entry and data review
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a dif...
....Read more...
Type: Permanent Location: Hattiesburg, US-MS
Salary / Rate: 21.75
Posted: 2024-04-17 08:47:58
