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Company Job Description/Day to Day Duties: Will be taking calls from members and providers. Will work closely with the care management team to ensure members are receiving proper care Will be working on the computer as…
Company Job Description: Perform case management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective…
Are you an experienced Provider Operations Coordinator looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you…
Will be on the phone with Medicare members to answer questions about their health insurance and to assist with open enrollment. High School Diploma 1+ years working with Medicare, Medicaid, Managed Care or Health…
Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network…
Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Analyzes clinical service requests from members or providers against…
Salary : Up to $68,000 plus 6% annual bonus opportunities & Excellent Benefits Package Shift: Monday to Friday 8:00AM to 5:00PM Assess the member's current health status, resource utilization, past and present…
Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Utilize assessment skills and…
This role is specific to the LTSS department. RN will be responsible for providing case management services and evaluating the necessity/appropriateness/efficiency of the use of Medical Services for Long-Term Support…
Ideal candidate will be professional at all times, assertive and accountable, have good timekeeping skills, flexible. Candidate should have drive, enthusiasm, initiative, commitment and self-motivation, respect for…
RN are responsible for conducting (hands-off/in-field (reimbursement rate for mileage = .535/mile)) assessments for a state mandated tool. Assessments will take approximately 2.5-3 hours per assessment. Will complete…
In conjunction with the PCP member member’s family and other pertinent members of the Interdisciplinary Care Team (IDT) CM completes a comprehensive assessment and develops a Person Centered Service Care Plan utilizing…
Retrieval, review, and abstraction of medical record data. Data entry into a HEDIS software system. Collaborate with clinical and non-clinical staff in provider offices for medical record retrieval. Candidate must pass…
These candidates will be working in the continued stay review department. They will be looking at emerging urgent inpatient admissions for medical necessity. Strong computer skills, positive attitude, and ability to…
test test Advantages of this Opportunity: Competitive hourly pay above regional average at $16-$17/hour! Longterm stability and individual professional growth potential from a national Healthcare company that continues…
Daily Responsibilities: Will be taking inbound calls and processing premium payments. Respond to high volume of inbound calls daily, 50-60 calls from members and providers Achieve individual performance goals as it…
Intro: We are aggressively seeking a RN Field Healthcare Transition Coach a Healthcare organization. As the Year 2016 is in full swing, this organization is very busy, and they need YOUR help. Take advantage of…
Need someone with talent and can tolerate high volume of production work. Can assist with art direction and branding. Need to be PROFICIENT with the various graphic design software solutions that the market demands.…
Census Development In today’s competitive market, maintaining census and occupancy as care patterns change is a crucial aspect of your facility’s success. Why? Census development drives revenue. Also, because…
Are you an experienced Behavioral Health Case Manager looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you…
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