Join Aledade’s growing clinical call center team in this 100% remote, telephonic role designed for LPNs looking to transition away from bedside floor stress into high-impact patient advocacy. As an LPN - Advanced Care Planning Specialist (internally called
Job Description Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the
Multi-Specialty Medical group is seeking a strong candidate, responsible for ensuring the continuity of care in both the inpatient and outpatient setting. Responsible for utilizing the appropriate resources within the parameters of contracts and patients health plan
Review Nurse This is a contract assignment that will start right away and end on April 30th 2024 Summary Description: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data
JOB DESCRIPTION Job Summary This position will offer remote work flexibility, but the individual hired for this role will need to reside in Florida. Provides lead level clinical support to healthcare services team supporting one or
Become a part of our caring community Humana Gold Plus Integrated is seeking Long-Term Services and Support (LTSS) Care Coordinators (Care Coach 1) in the state of Illinois to assess and evaluate members needs and requirements
The Senior Post Acute Transition Specialist functions as a highly specialized strategist, exercising significant autonomy to spearhead post-acute care initiatives for a flagship Enterprise Practice and its affiliated health system. This role serves as an executive-level
Job Title: Medical Virtual Assistant (Interventional Pain Management) Position Type: Full-Time Work Hours: 8:30 AM – 5:30 PM PDT Work Days: Monday to Friday Salary: $5–$6 per hour, depending on experience Job Code: DEA-AC Workplace: Remote
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the
Job DetailsLevel: ExperiencedJob Location: Involuntary Remote TMC - Remote, SC 29486Position Type: Full TimeSalary Range: $85,000.00 - $92,000.00 Salary/yearJob Shift: DayJob Category: InsurancePlease make sure to complete all the questions in the application and continue through
Become a part of our caring community Humana Gold Plus Integrated is seeking Long-Term Services and Support (LTSS) Care Coordinators (Care Coach 1) in the state of Illinois to assess and evaluate members needs and requirements
Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members,
Job DetailsLevel: ExperiencedJob Location: Involuntary Remote TMC - Remote, SC 29486Position Type: Full TimeEducation Level: High School Diploma or GEDSalary Range: $85,000.00 - $92,000.00 Salary/yearTravel Percentage: NoneJob Shift: DayJob Category: Admin - ClericalPOSITION SUMMARY: The medical
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the
Job Title Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs.
M&R Coding Clinical Analyst Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by
Specialised Part-Time Consulting Opportunity for Nursing Professionals We are sharing a specialised part-time consulting opportunity for nursing professionals experienced in patient care, clinical monitoring, medication administration, clinical documentation, care coordination, and structured healthcare workflow review. This
Job Overview Pay Range: $46.76hr - $51.76hr Requirement/Must Have 5+ years Clinical nursing experience. 2+ years Care Management. Bachelors Degree in Nursing. In lieu of a Bachelors degree, an additional 4 years of relevant work experience
Essential Duties and Responsibilities: - Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. - Issue approvals, denials or recommendations based on contract requirements.
Essential Duties and Responsibilities: - Responsible for completing medical and/or behavioral health assessments within contract requirements - Conducts on-site, video call and/or telephonic assessments to determine an individuals needs for services and supports, eligibility, level of care