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Participates in the strategic planning process and works closely with the VP Managed Care Operations. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology.
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Participates in the strategic planning process and works closely with the VP Managed Care. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services.
$144,206.41 - $237,931.2 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Qualifications: RN Florida StateBachelor of Sciences degree or in other related fieldFive plus years’ experience in Chronic Care Management, Transitional Care Management and/or Care Coordination programs.
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Masters in Social Work Care Management discharge planning experience Knowledge of state and federal guidelines pertinent to care management Current working knowledge of discharge planning, utilization management, care management, performance improvement and managed care reimbursement Knowledge of state and federal guidelines pertinent to Care Management.
$24.661 - $36.991Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Minimum three years progressive professional experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required.
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Serves as the Tenet leads with Tenet National Director Clinical Denials, Sr. Director Revenue Cycle, hospital CFOs, Directors Revenue Analysis (DRAs), and Managed Care Contracting to design concurrent processes to secure authorizations and prevent clinical denials.
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Knowledge of managed care principles and practices with an emphasis in Grievance and Appeals and/or Utilization Management. Apply the use of clinical judgment to identify and coordinate referrals to appropriate departments or programs for member identified needs, such as Case Management, Behavioral Health, Managed Long Term Services and Supports (MLTSS) and Quality.
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Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management, and managed care reimbursement.
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You will be joining one other professional at the Neuro Spine Institute while focusing on interventional pain management with minimal medical management. Providence Medical Group is seeking a full-time Pain Management physician to join its team in Eureka, California.
$383,007 - $581,771 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Utilization Management Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
$33.3 - $44.49 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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This role will report into DaVita's Integrated Kidney Care (IKC) Program Management team, which oversees programmatic success across all Value Based Care (VBC) product lines. We are a highly motivated, fast-paced team with extensive experience in operations, managed care, and consulting, and are at the center of DaVita's strategy to evolve from fee for service to value based care.
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QUALIFICATIONS & EXPERIENCE REQUIREMENTSGraduate of an accredited school of nursing; LPNValid LPN license in the state employedThree years of experience in a long term care environment preferredExperience with the MDS/RAI process and/or case management preferred JOB RESPONSIBILITIESThe MDS Nurse RAC (Resident Assessment Coordinator) reports to the Executive Director and is responsible for accurate and timely completion of mds assessments and coordination of the RAI process.
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ScionHealth - Community Care Hospital Division is seeking a per diem / prn nurse RN Case Management for a per diem / prn nursing job in Columbus, Georgia. Job Description & Requirements Specialty: Case Management Discipline: RN Duration: Ongoing Up to 36.00 hours per week Employment Type: Per Diem Description At. St. Francis-Emory Healthcare, we recognize that our patients deserve qualified, engaged, and competent healthcare professionals.
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Opportunity for an OB/Gyn physician to work in Rural Health Setting.
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By bringing together the scope and reach of Jefferson Health – a top integrated health care system with a vast array of home health and hospice caregivers and volunteers– and the extensive management capabilities, operating platform, and clinical experience of BAYADA – a leading not-for-profit home health care provider, Jefferson Health at Home by BAYADA will strengthen and extend the continuum of care in the region.
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care management managed jobs Title: management Company: Universal Health Services in Rogers, Arkansas
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