- UpvoteDownvoteShare Job
- Suggest Revision
You will lead all aspects of utilization review/quality assurance, directing case management. This role expands Aetna's medical management programs to address member needs across the continuum of care.
$174,070 - $374,900Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Summary of Essential Duties: Assist with in office procedures, clinic flow, practice management, and help to facilitate continuity of care Manage outpatient chemotherapy schedule, set up new oral chemotherapy medications electronically and manage monthly prescriptions Telephone triage of clinic patients with needs ranging from chemotherapy, results review, symptom management Manage acute and chronic side effects after autologous stem cell transplant.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from all lines of business using respective national/state, health plan, nationally recognized guidelines.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies.
$286,104 - $397,743 a yearFull-timeRemoteExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
Processes provider enrollment by: gathering and performing detailed and thorough review of the moderately complex information used to submit the enrollment applications; independently preparing and submitting data and applications to the contracted and government payors in a manner commensurate with their expectations, policies and accreditation standards; independently communicating enrollment status to all stakeholders in a clear and timely manner; and may be notarizing public documents.
$68,100 - $88,110 a yearExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
Ensures timely review of all case work to meet business turnaround times. May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.
Full-timeRemoteExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
Chart auditing, CPT and ICD-9 review. The Medical Assistant will be responsible for assisting in examination and treatment of patients under direction of the Physician. Vocational certificate in Medical Assistant.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
Documenting patients' medical information, including medical history and review of symptoms within EHR of patients chart. Monitoring and documenting patient symptoms for physicians' review during clinical exams.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
Actively review utilization patterns and appropriateness in areas such as emergency department charges, specialist consultations, downstream utilization of limited access and high utilization medical resources from both a physician and supportive/ancillary services.
Full-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
- Suggest Revision
Review ORR portal for compliance with medical information upload requirements and ensure updates are input as needed for safety and timely discharge. Position Summary: The Medical Assistant will assist the Medical Coordinator to arrange or partner with other health professionals regarding health and safety standards for out-of-home placement, licensing requirements, disease reporting requirements for care providers, immunizations for children, injury prevention for children, medication management and knowledge of community health and mental health resources for children.
ExpandApply NowActive JobUpdated Today
FEATURED BLOG POSTS
What is a W-9 and How to Fill One Out
When you began working for yourself, you probably didn’t account for the tax reporting work that will fall on your shoulders each year. If you’re a freelancer, independent contractor, or business owner, filing your taxes is not as simple as uploading your W-2 form into some online tax preparation software. Most self-employed people need to complete a W-9 as a step for accurately reporting their earnings to the IRS. Below, you can learn how to fill out a W-9 and when to submit it.
Tightening the HR budget in 2023
With the state of the economy still uncertain, 2023 is expected to be approached with much anticipation. Human Resource leaders have many concerns, including how they will manage to accomplish their goals with budget belts already getting snug. Let’s look at some of the factors that the new year is projected to bring for HR and how to prioritize budgets to reach human capital objectives.
A Comprehensive Guide to Becoming a Better Conversationalist
Have you ever stood awkwardly next to someone at a party because you didn’t know what to say to them? How about at a networking event or on a first date? You're not alone if you’ve ever experienced this uncomfortable silence. Many people struggle to master the art of being a great conversationalist.
Why is Non-Verbal Communication Really Important?
In a world where words and phrases rule daily communication, you may wonder why non-verbal communication is important. Whether you realize it or not, you communicate more with nonverbal actions than you do with verbal communication. When you interact with your peers, people are reading your body language, facial expressions, voice, and many other factors that help fill in blanks that words can't fill.
Making Hybrid Work More Efficient
Covid was a catalyst for change in the work environment. Keeping people safe and helathy was the initial goal for employers, but the unintended result was the considerable demand in remote work. Now, onsite work has been dramatically altered to remote work, which is now transforming into a combination of the two: hybrid work.
How Can HR Technology Help Retain Employees?
Human resources' rapid adoption of technology has led to new ways of streamlining human capital management. Based on the IEE Global Study, these technologies changed how HR handled recruitment and retention in 2022. This includes tech like
Why is Time Management Important? 10 Crucial Importances of Time Management
We’ve all been there before. What starts as a relaxing evening scroll quickly becomes a full-blown binge. You blink, and it’s midnight - throwing off your entire next day before it even starts. And at its worst, this indulgence might leave you feeling behind on things you planned to finish that night. This is why time management is important.