The Medical Director will conduct medical necessity determinations for inpatient and post-acute care while ensuring compliance with CMS and NCQA standards. They will also collaborate with care management teams and lead peer-to-peer discussions to optimize clinical outcomes and utilization trends.
The developer will design, implement, and support Salesforce Health Cloud solutions while integrating third-party software and enterprise systems. They will also collaborate with cross-functional teams to monitor workflows, resolve technical issues, and participate in Agile development cycles.
The Program Manager will lead the end-to-end implementation and migration of the QNXT Claims workstream, ensuring alignment across cross-functional teams. They are responsible for managing project governance, vendor relationships, and operational readiness for go-live.
The developer will design, implement, and support Salesforce Health Cloud solutions while integrating third-party software and enterprise systems. They are also responsible for monitoring workflows, resolving technical issues, and collaborating with cross-functional teams in an Agile environment.
Design, develop, and implement Salesforce Health Cloud solutions including system interfaces and data integrations. Collaborate with administrators to optimize workflows, perform system testing, and provide technical support within an Agile environment.
