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Develops Transfer Center protocols that focus on patient-centered care, to ensure transfers are managed effectively. Preferred: Prior experience managing or director of a Transfer Center Program.
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Merrill Family of Senior Living Communities, a privately-owned family company with a proud history of success, is currently hiring a Resident Care Director, LVN or RN license required, at Merrill Gardens at Bankers Hill in San Diego, California.
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Director of Nursing, management or supervisor experience in long-term care, restorative or geriatric nursing. Maintain current knowledge of applicable managed care, Medicare and state Medicaid regulations, reimbursement systems and methodology.
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Currently are seeking fitness-conscious, wellness-oriented medical professionals (PA, APN, APRN, FNP) in connection with a planned expansion of clinical offerings and rapid escalation of remotely managed care options.
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Preferred board certified or board eligible in primary care specialty (Family Medicine, Internal Medicine) with administrative experience in corrections and/or managed healthcare delivery.
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Any offer of employment that materializes as a result of this job opportunity is contingent upon Centene and Virginia Total Care being selected to provide managed care Medicaid services, and executing a contract with the Commonwealth thereto, under Cardinal Care Managed Care (CCMC) RFP #13330.
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Engages in ongoing contact with managed care company representatives to provide initial clinical data for pre-certification and concurrent case review to ensure authorization of all necessary days at the most appropriate level of care.
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Model and actively promote the UI Health Care ICARE Core Values and Behaviors. Contribute to the oversight and delivery of health care services and the academic mission in the Department of Internal Medicine through leadership and management of clinical/technical specialty services, revenue cycle, support services, clinical education, and research programs.
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Masonicare manages the assisted living services program in several managed care communities throughout the state. Provides assistance with essential activities of daily living and personal care to residents based on age, needs and abilities of the resident, including bathing, dressing and undressing, ambulating, toileting, assistance with meals and nourishment's, personal hygiene (shaving, dental hygiene, nail, hair and foot care), transferring using proper body mechanics and appropriate assistive devices and care of ADL devices such as eyeglasses and hearing aids.
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Tracks authorizations from managed care organizations and requests when due. Must have a good working knowledge of local community based services, the NYS Medicaid System, The DOH Universal Assessment system and experience in obtaining services through waivered and/or managed Medicaid plans.
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Laurel Health Care Company is a national provider of skilled nursing, subacute, rehabilitative, and assisted living services dedicated to achieving the highest standards of care. You will supervise nursing care provided by registered nurses, licensed vocational/practical nurses and STNA/CNAs.
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Knowledge of managed care and insurance- as it relates to mental health and substance abuse benefits. Has a general understanding of treatment, levels of care, and best practices for treating substance use and dual diagnosis patients.
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The director is also responsible for facilitating positive, professional relationships within the managed care organization, providers, and the community. Works with Staff and Senior Management to develop and implement provider contracting strategies and provider service strategies to improve member access and enhance Provider satisfaction with the Health Plan. Primary Health Plan liaison for Claims, Member Services, Care Management, and other key departments within the Health Plan. Responsible for facilitating positive, professional relationships within the managed care organization, Providers, and the community.
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The CRS manages the overall resident assessment process and tracking of all Medicare/Managed Care/Medicaid case mix documents in order to ensure appropriate and optimal reimbursement for services provided within the Care Center.
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Observes and reports changes in the residents' physical condition and cognitive/emotional status to ALSA Supervisor or Director of Assisted Living Services, as needed. Certified Nursing Assistants in the Masonicare ALSA Service program assist residents with activities of daily living and personal care to maximize independence, freedom of choice and quality of life.
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