Director Utilization Management and Effectiveness Clinical Operations-SWHR CIN

at Texas Health Resources
Location Dallas, TX
Date Posted March 27, 2020
Category Provider Relations
Job Type Full-time

Description

Previous clinical background experience with thorough knowledge of state and federal guidelines, CMS and NCQA, URAC accreditation bodies, participating provider agreements, HIPAA and other related regulatory requirements for Medicare Advantage and Commercial Health Plans as applicable required. Bachelor's Degree in Nursing or related healthcare field required and will also consider M.D....