The Clinical Manager plans, organizes, manages, and evaluates clinical operations for Medical Review, ensuring compliance with regulations and accurate claim decisions.

The Billing and Enrollment Specialist processes membership enrollments, assists in billing, cash posting, and generates ID cards, ensuring compliance and addressing inquiries from members and stakeholders.

The Utilization Management RN evaluates medical services for efficiency and necessity, utilizing clinical knowledge to authorize services and work with Medical Directors on questionable cases.