Profile Summary: Favorably impact Stop Loss risk profile through early identification of potential high cost patients. Profile Description: • Serves as a subject matter expert in the evaluation of medical information to clarify diagnoses, evaluate the
Profile Summary: Favorably impact Stop Loss risk profile through early identification of potential high-cost patients. Profile Description: Serves as a subject matter expert in the evaluation of medical information to clarify diagnoses, evaluate the severity of
The Clinical Consultant provides clinical and operational support as a U.S. Healthcare Subject Matter Expert, providing various clinical support services and operational guidance for business processes, to include Case Management, Utilization Management, Clinical Coverage Preservice, Claims and