Position Summary. The Director of Administrative Operations is responsible for management and oversight of inpatient, including related case management and discharge planning. The position is directly responsible for managing the daily administrative operations of the Medical Management Department. Responsibilities include development and implementation of procedures, training, and processes to assure compliance with RMG policies and procedures. ...
Position Summary. The Inpatient Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified patients during an acute care episode. Assesses and develops a care plan in collaboration with the admitting, attending and consultant physicians, and other healthcare practitioners. The goal of the Inpatient Case Manager is to effectively manage the patients during their hospital...
Position Summary. The role of the Nurse Reviewer is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization specialty referral requests as well as acute inpatient admission. The Nurse Reviewer will review for appropriate care and setting, and following guidelines/policies, will approve services when indicated. If not indicated, Nurs...
Position Summary. Provides primary health care and performs selective medical services under the direction of their Supervising Physician and Medical Director. Essential Duties and Responsibilities include the following. Obtains complete medical history and physical data on patients. Reviews patient records. Interprets and integrates data to determine appropriate diagnostic and therapeutic procedures needed. Performs a complete physical exam and ...
Position Summary. The Inpatient Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified patients during an acute care episode. Assesses and develops a plan of care in collaboration with the admitting, attending and consultant physicians, and other healthcare practitioners. The goal of the Inpatient Case Manager is to effectively manage the patients during their hospi...
Position Summary. The Inpatient Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified patients during an acute care episode. Assesses and develops a care plan in collaboration with the admitting, attending and consultant physicians, and other healthcare practitioners. The goal of the Inpatient Case Manager is to effectively manage the patients during their hospital...
We are looking to hire an experienced Respiratory Case Manager to join our clinical care team. Position Summary. This individual will be accountable for providing clinical care management and coordination support to high-risk members with pulmonary diagnoses/conditions in the North Region of Regal Medical Group .This position is embedded in a pulmonology clinic and supports members enrolled in Regal pulmonary disease management programs in order ...
Essential Duties and Responsibilities include the following. . Assist the pharmacist in the following areas while under the Pharmacist’s supervision. Verification of health care insurance for non-covered medications. Conducts medication reconciliation. Help in areas such as scheduling and patient reminders through phone calls. Medication histories and health histories can also be documented by technicians, as can chart construction, filing, and t...
. The Compliance Special Investigator & Auditor reports to the Director of Compliance & Oversight (and SVP of Compliance-Compliance Officer). This position staffs and services the Compliance Department’s Special Investigations Unit’s (“SIU”) activities to detect, investigate, and respond to (collect overpayments, and/or support necessary and required reporting and notifications) substantiated instances of Fraud, Waste, Abuse, and/or Non-Complianc...
Position Summary. . The Lead Inpatient Care Manager (Lead) is responsible for is responsible for being the “first line” resource for inpatient review staff. This includes questions regarding procedures, training, and processes to assure compliance with RMG policies and procedures. The Lead assists the Manager of Inpatient Case Management with daily management of inpatient review, auditing functions, and ensuring that all staff provides a level ...
Position Summary. . Provides primary health care and performs selective medical services under the direction of their Supervising Physician and Medical Director. . Essential Duties and Responsibilities include the following. Obtains complete medical history and physical data on patients. Reviews patient records. Interprets and integrates data to determine appropriate diagnostic and therapeutic procedures needed. Performs a complete physical exam ...
Position Summary. . The Inpatient Case Manager is responsible for the assessment, treatment planning, intervention. monitoring, evaluation and documentation on identified patients during an acute care episode. Assesses and develops a plan of care in collaboration with the admitting, attending and consultant. physicians, and other healthcare practitioners. The goal of the Inpatient Case Manager is to effectively. manage the patients during their h...
