Position Summary. The Inpatient Care Coordinator is responsible for supporting the process that manages all hospital and skilled nursing admissions, concurrent review, and discharge planning. The goal of the Inpatient Care Coordinator is to effectively support the in-patient management process by assuring the right information is provided timely to the RMG administrative management team, hospitalists' and care managers. Essential Duties and Respo...
Position Summary. The Inpatient Care Coordinator is responsible for supporting the process that manages all hospital and skilled nursing admissions, concurrent review, and discharge planning. The goal of the Inpatient Care Coordinator is to effectively support the in-patient management process by assuring the right information is provided timely to the RMG administrative management team, hospitalists' and care managers. Essential Duties and Respo...
Work schedule. After hours12 pm-12 am and Every other weekend 12 pm-12 am. Position Summary. The After Hours Transfer Coordinator supports the process that manages the Afterhours Call Department. The goal for this position is to effectively support the Afterhours Call Services management process by assuring the right information is provided timely to the team. This includes ensuring that all necessary clerical functions are completed accurately a...
Required: Two weeknights (4pm-12:30am) and weekends for 12 hour shifts (8a-8p), including holidays 6 out of 9 holidays(12 hour shifts). Position Summary. The After Hours Nurse Case Manager performs triage functions by providing support and guidance, linking members and their families to healthcare services that meet their needs and serving as a communication bridge amongst and between members, families and the care team. Coordinates resources int...
Essential Duties and Responsibilities for this position are the following. To judiciously manage resources utilized in the care of inpatients so that their stay is efficient, expedited and evidence based. To take into consideration post-discharge patient needs throughout the hospital stay to ensure continued care after discharge and reduce the likelihood of readmission. To ensure and enable communication between all stakeholders in real time so t...
Under the direction of the. Senior Vice President of Operations. this position is responsible to. assign proper coding for out-patient hospital billing for correct reimbursement The of Manager/Coding will interact with other departments, clinic personnel, and outside providers in a professional and friendly manner, to create and maintain a positive relationship with our internal and external customers. . Direct day to day operations of the HCC ...
Under the direction of the. Clinic Supervisor. this position is responsible to. answering office telephone calls, managing tasks for the providers, submission of referrals, ability to access, understand, and process tasks and duties in the electronic medical records system, have HEDIS and I-Star knowledge and participation, and act under the supervision of the Clinic Supervisor. They must maintain adherence to policies, procedures and regulations...
Summary of position. Manager of Outpatient Case Management is responsible for management and oversight of Regal Outpatient Care Management Programs. The Program and Department coordinate and manage care of enrollees designated at high risk for progression of disease, clinical decline, and in need of urgent or emergent care. Directly responsible for daily operations of the Program and Department and for operational partnership with concurrent rev...
Advanced Practice Clinician (Nurse Practitioner/Physician Assistant) will provide pediatric health care and performs selective medical services under the direction of their Supervising physician and Chief Medical Officer. . Essential Duties & Responsibilities include the following. Obtain pertinent health history and perform appropriate physical examinations on any patient who presents for care. Formulate a diagnosis and plan related to the pati...
This position is responsible for maintaining routine auditing functions and providing feedback on departmental activities, to assure compliance with all health plan and regulatory agencies, including CMS, DMHC, and DHS. This position includes the responsibility for routine hospital and professional audits, complex audits on individual or random, training and focused claims to identify exceptions to established claims adjudication requirements for...
Position Summary. . Responsible for greeting patients, collection of payments, insurance eligibility verification, delivering excellent customer service, answering phone calls, addressing patient questions and providing overall welcoming environment. . Essential Duties and Responsibilities include the following. Keep work area, lobby & conference rooms neat and organized. Patient Services Representatives are responsible for supporting and assisti...
Position Summary. . Provide efficient and accurate information to prior authorization requests. Ensure that correct benefits, co-pays and financial responsibility are provided to Prior Auth requestors. . Essential Duties and Responsibilities include the following. Anticipate our customer needs: Understand the process and job guidelines in order to provide accurate and in timely manner information to Prior Auth department so they can properly auth...
