multidisciplinary case management/medication therapy management program, P&T, developing and conducting educational initiatives... enrolled in the case management program and assist with developing treatment plans. Provide medication therapy management...
Certified Nurse (OCN), Certified Case Manager (CCM), and Patient Advocate Certification Specialist (PACS). Preferred candidates... criteria. Preferred experience in case management or care coordination, including telephonic patient support and/or working...
telephonic outreach to members who are identified as needing preventive services in support of quality initiatives and provides... and other affinity programs as available. Maintains confidentiality of business and protected health information. Reports to: Manager...
. Adjusts and assigns unscheduled visits as required i. Uses hand-off report mechanism to provide next shift/case manager... of the Clinical Manager – works weekend shifts assisting team leader and scheduling. Completes triage of incoming calls...
as case finding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being... requires collaboration with manager and providers to ensure clinical protocols and processes are followed and manage clinical...
. Adjusts and assigns unscheduled visits as required i. Uses hand-off report mechanism to provide next shift/case manager... of the Clinical Manager – works weekend shifts assisting team leader and scheduling. Completes triage of incoming calls...
. How you will make an impact: Telephonic Care Coordination. Identifies opportunities for engagement of members and their families... Certification in Ohio is required. Preferred Skills, Capabilities and Experiences: Knowledge of care-coordination and case...
is granted as required by law. The LTSS Service Coordinator-RN is responsible for overall management of member's case... within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case...
and/or assigned facilities contractual arrangements. Examples include but may not be limited to DRG (APR and MS), case rate... Manager or department Manager. Requirements EDUCATION: (Minimum education & certifications required) Registered Nurse...
changes with Manager to review and pass on to Sales team Execute ad hoc forecast uploads that are off cadence... that may come through email, tracking a comprehensive list to be reviewed with Manager and Merch Team Create Investment Review...
, with overall responsibility for the member's case. As required by applicable state law and contract, the Clinician contributes..., assisting the responsible RN with telephonic or face-to-face assessments for the identification, evaluation, coordination...
board-certified physician with interest and experience in managed care utilization and case management to support our team... determinations and provide support and guidance to the case management programs. You have a passion to make healthcare...
is granted as required by law. The LTSS Service Coordinator-RN is responsible for overall management of member's case... within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case...
where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently... with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim...
resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager... in care management programs and/or health and disease management programs. Provides telephonic support for members...
, Case Manager, Preventive Services, Subrogation, Quality of Care Referrals, etc.). Participates in data collection/input.... Promotes enrollment in care management programs and/or health and disease management programs. Provides telephonic support...
with Case Management to ensure authorizations are complete and accurate. Documents in the electronic medical records, obtaining... responsibilities as outlined in department/service area procedures within established time lines. Communicates needs to case management...
benefits when information is available. Collaborates with Case Management to ensure authorizations are complete and accurate... procedures within established time lines. Communicates needs to case management / social work caregivers through phone contact...
is responsible for overall management of member's case within the scope of licensure, develops, monitors, evaluates, and revises the... health care across the care continuum. How you will make an impact: Responsible for performing telephonic and face...
as a backup for Quality & Compliance Manager and Standards & Execution Specialist. Participate in other tasks and projects... to work/life wellness support including no cost unlimited telephonic counseling services Opportunities for leadership...