- CVS Health (Annapolis, MD)
- …standards, where applicable, while adhering to company policy and procedures. - Places outbound calls to providers under the direction of Medical - Management Nurses ... to obtain clinical information for approval of medical authorizations. - Uses Aetna Systems such as QNXT, ProFAX, ProPAT, and Milliman Criteria. - Communicates with Aetna Nurses and Medical Directors, when processing transactions for members active in this… more
- CVS Health (Annapolis, MD)
- …Supports comprehensive coordination of medical services through composition and auditing of approval and denial letters. Position is responsible for learning and ... producing letters for up to 13 centralized Medicaid health plans throughout the day, shifting and prioritizing work to meet turn around times. Promotes and supports quality effectiveness of the Healthcare Services. Maintains accurate and complete documentation… more