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The Clinical Psychologist leads behavioral health coverage determination, ensuring patient safety, developing clinical policies, and guiding quality improvement initiatives in care management.

The Clinical Psychologist ensures correct behavioral health coverage, leads clinical initiatives, participates in quality improvements, and supports regulatory compliance. Responsibilities include training staff, liaising with external partners, and analyzing healthcare data.

The Incident Management Investigator conducts clinical investigations related to incidents, collaborates with various stakeholders, develops care plans, and ensures compliance with regulations.

The Claims Specialist III resolves claim adjustment requests, processes claims, and ensures compliance with regulations while supporting providers with inquiries and training peers.

The Assistant Clinical Director manages care coordination activities, ensures staff performance, develops policies, and oversees compliance with regulations.

The Assistant Clinical Director oversees care coordination, ensures regulatory compliance, manages staff performance, and handles budgeting and operational tasks.

The Clinical Appeals Nurse processes clinical appeals and prepares for state hearings, ensuring compliance with regulatory standards while collaborating with medical staff and communicating with members and providers.

The Actuarial Analyst II conducts analyses and provides recommendations to support corporate initiatives. This involves profitability reporting, evaluating assumptions and government reimbursement, and participating in cross-functional teams.

The Behavioral Health Provider Engagement Specialist III manages provider contracting, recruitment, and engagement strategies, ensuring compliance and effective partnerships to enhance provider network performance.

The AVP, Finance oversees financial operations, manages budgets and forecasts, leads strategy developments, and ensures compliance with financial reporting standards.