Summary: The main function of a Case Manager is to organize and facilitate patient care and work with healthcare..., and coordinating care. Job Responsibilities: Coordinate and provide care that is safe, timely, and effective. Manage case...
Job Description: Your Role The Federal Employee Program (FEP) team performs integrated case management (CM... care experience preferred. Comprehensive knowledge of case management, discharge planning, utilization management, disease...
Job Description: Your Role The Care Management team will serve to support the mission of the department... to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures...
of care issues, service or treatment delays and intervenes or as clinically appropriate Refer to Case Management when there...Job Description: Your Role The Utilization Management team reviews the inpatient stays for our members...
and expedites access to appropriate care for members with urgent needs Provides referrals to Case Management, Disease Management...Job Description: Your Role The Utilization Management Prior Authorization team processes accurate and timely prior...
, and apply interventions when clinically appropriate Provides referrals to Case Management, Disease Management, Appeals and Grievance...Job Description: Your Role The Utilization Management team reviews the inpatient stays for our members under the...
, and case management software. Excellent organizational skills and attention to detail, with the ability to manage multiple... environment. Key Responsibilities: Support attorneys in managing a caseload, including document preparation, case file...
, and case management software. Excellent organizational skills and attention to detail, with the ability to manage multiple... environment. Key Responsibilities: Support attorneys in managing a caseload, including document preparation, case file...
management. Utilize advanced eDiscovery platforms and tools to streamline workflows. Qualifications: Minimum 3-5 years... and employment law or case management is a plus. Benefits: Opportunities for professional growth and work-life balance...
to attend the office 3 to 5 days based on business needs Responsibilities: Participates as a member of the State Management... potential matches and assist in case assignments. Assists Coordinators in locating appropriate homes when disruptions occur...
Job Description: Your Role The Medical Management team ensures that Blue Shield is on the cutting edge of medical... Director, Medical Policy will report to the Vice President of Medical Management. In this role you will be accountable...
utilization management and fraud waste and abuse case evaluations Participate with the quality management function in the... years of Health Plan experience in commercial, Medicare Advantage and Medi-Cal utilization management, case review...
utilization management and fraud waste and abuse case evaluations Participate with the quality management function in the... A minimum of 3 years of Health Plan experience in commercial, Medicare Advantage and Medi-Cal utilization management, case review...
care management, preferably in home care operations. 5. Ability to market aggressively and deal tactfully with customers... relationships with current and potential referral sources. 5. Ensures seamless transition of patients to home care by providing...
examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related... Friday, 8:00am to 5:00pm. Pay range is $20-$22/hr. Responsibilities: ESSENTIAL DUTIES AND RESPONSIBILITIES TO PERFORM...
for submitted procedures/claims appeal Initiates referrals for members to Case Management as needs are identified Qualifications... and prioritizes cases to meet required regulatory turn-around times Prepares and submits clinical case reviews to the Medical...
. We have a strong multidisciplinary team consistently involved in the care and well-being of our patients and consists of case management, social services.... Unit staffing consists of 4:1 RN ratio for telemetry patients and 5:1 RN ratio for Medical Surgical patients...
in file handling. Fully and effectively utilizes available technology, case management system and automation. Travel..., proactive case handling and will have the opportunity to use your legal expertise and litigation skills to independently handle...
to all best practices in file handling. Fully and effectively utilizes available technology, case management system and automation. Travel... case handling and will have the opportunity to use your legal expertise and litigation skills to handle a caseload...
with customers and the community. 5. Knowledge of corporate business management. 6. Demonstrates good communications skills... allocations for the marketing department. Monitors allocation of resources according to budgetary limitations. 5. Continuously...