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• This RN Case Manager will be assisting members that have dual enrollment which means age 65 and over and have low income and resources • This RN Case Manager is a field case management position about 40% field the…
Responsible for the quality review of claims to enhance the clinical, network, and case management services. Also responsible for coordinating all aspects of continuing clinical, nursing, and Certified Case Manager…
Position Purpose: Perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions.…
Are you an experienced Data Entry Rep 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 answered “yes"…
Job Description: Are you an experienced Registered Nurse 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…
Are you an experienced RN 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 answered “yes"…
Daily Responsibilities: • Recruiters work internally for a large Managed Care Organization • Assess recruiting needs and ID key recruitment strategies to attract highly qualified candidates • Conduct in-depth screening…
This position is responsible for safely and effectively transitioning members from acute or inpatient care to lower levels of care and/or home in a cost efficient manner. Provides assessment, planning, implementation,…
Handled 40-50 outbound phone calls per day Calling in regards to the Health Risk Assessments that were completed to discuss Case Management services/options and connected them with a Case Manager Must be computer…
Manages and coordinates the completion of enterprise. functional and/or departmental projects and key initiatives from start to finish. Drives enterprise. functional and/or departmental initiatives and ensures project…
-Coordinates the care and services of Long Term Care members across the continuum of illness. Promotes effective utilization and monitors health care resources. Assumes a leadership role within the interdisciplinary…
You, as the Registered Nurse will be held responsible for providing professional nursing care by assessing, planning, implementing and evaluating the care of patients under the supervision of a clinician or RN,…
Performs initial and ongoing clinical assessments via telephone calls to clients for the purpose of assessing client's situation with regards to healthcare needs, cultural implications and support systems in place.…
Receive, document and respond to all contacts including member, client and pharmacy inquiries about Benecard PBF benefits, policies and procedures Investigate and resolve member complaints and concerns in cooperation…
Are you an experienced Pre-op/ Recovery RN, in Ann Arbor, Michigan, looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing…
Day to Day Duties: These candidates will be looking auditing charts to make sure the health plan as a whole is taking necessary and correct action. They will be pulling information from charts for core measures and…
Day to Day Duties: This person will be reviewing charts to ensure members are receiving the most appropriate/cost effective care. They will be reviewing the progress of discharge planning to make sure they take…
More Insight of Daily Responsibilities: • Perform duties and functions to comply with quality improvement programs according to state requirements. • Support Quality Assurance Performance Improvement work…
Job Description: Are you an experienced Customer Service Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing…
Are you an experienced Operating Room RN, in Germantown, MD 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…
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