and/or proposes changes to the behavioral health care plan as appropriate Works collaboratively with the outreach team and Fallon... observes HIPAA regulations and Fallon Health’s policies regarding confidentiality of member information Strictly observes...
of analytic experience preferred and 5+ years of experience within the managed care industry preferred. #P02 Fallon Health...Responsibilities Consults, designs and produces health care information, business analysis, market analysis, geo...
for Health Aides on an annual basis. Fallon Health provides equal employment opportunities to all employees and applicants... participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely...
. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits...
proactive follow-up activities with provider and/or Fallon Health staff. Validate data received by providers and update... and procedure (i.e., Fallon Health Service Level agreements) issue resolution timeframes, PUNKS, QNXT case inventory/assignments...
authorizations within parameters of Fallon UM guidelines Review post-acute authorization requests, validate eligibility... position, preferably in health care. Experience in a managed care or call center setting or physician’s office; knowledge...
. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits...
experience preferred Fallon Health provides equal employment opportunities to all employees and applicants for employment... from an accredited school of nursing mandatory Bachelors (or advanced) degree in nursing or a health care related field preferred...
Responsibilities Note: Job Responsibilities may vary depending upon the member’s Fallon Health Product Member... Health benefits as appropriate and if member needs are identified but not covered by Fallon Health, works with community...
to 2 years college preparation) Fallon Health provides equal employment opportunities to all employees and applicants...
determination preferred. Must possess strong interpersonal, analytical and communication skills. Fallon Health provides equal... electronic health record Generate Transitions of Care Templates to accurately reflect transitions and level of care Track...
member and provider inquiries received through Fallon Health's 1-800 numbers, as well as providing direction on Plan policies... About Fallon Health: Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse...
, referral and authorization process, benefit coverage, and provider contracts preferred. Fallon Health provides equal...
and provider contracts preferred. Fallon Health provides equal employment opportunities to all employees and applicants...