Triage Nurse firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and
Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within Medicare
Essential Duties and Responsibilities: - Lead and execute sensitive, high-risk investigations (e.g., harassment, discrimination, retaliation, serious misconduct), including matters involving senior leaders and significant organizational risk; gather evidence, conduct interviews, assess credibility, and document findings. -
Essential Duties and Responsibilities: - Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments. - Provide written clinical rationales for CA Workers Compensation cases. - Review, organize
Essential Duties and Responsibilities: - Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations. - Render determinations for cases assigned. - Resolve all other technical issues within reconsideration assigned. - Review cases or sites