This site works a 4/10 Alternative Work Schedule. 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 P...
Position Summary. . Working as part of the patient care team the Nurse Practitioner or Physician Assistant will provide services to members in Clinic, Office and Urgent Care settings working within the NP / PA scope of practice and in compliance with the collaboration protocol of designated Supervising Physician. . Essential Duties and Responsibilities include the following. . Obtain and document all pertinent information in patient’s charts. Mai...
The Lead Inpatient Transfer 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 Transfer Case Manager is to effectively identify which Medi-Cal members nee...
. We are looking for an Outpatient Renal Case Manager RN to join our team. . . The Outpatient Case Manager RN is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk members. The Outpatient Case Manager RN will assess and develop a care plan in collaboration with the admitting, attending and consulting physician, the member and other health care practitioners. The go...
Essential Duties and Responsibilities include the following. . 1.Maintain the workflow of all departmental projects. . 2.Ensure priority sorting, batching & logging by provider and provider type for all correspondence. . 3.Provide reports and on-going updates to Claims management. . 4.Assist in the processing of appeals (reconsiderations), special projects and reconciliations from all sources. . 5.Oversees staff activities to maintain high level ...
