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The CMLN is responsible for working closely with placement coordinators to choose an appropriate location for members to transition from the hospital to the SNF, with the Outcomes Manager to discuss medical needs of members, with nursing home care coordinators to gather member information, and with MD/ARNP/RN to ensure that members are treated in the appropriate post-acute care setting.
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The Care Manager - SW is a key member of an integrated Care Team which includes a Nurse Care Manager and an Advanced Practice Provider. Monogram's in-home approach utilizes a national nephrology practice supported by case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs.
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Maintains positive and open communications with physicians, interdisciplinary care team members, coding staff, Coding Compliance Manager, Department Director and Emergency Trauma Dept. The CDS reviews and screens ED inpatient admissions and observations as specified by the facility's Utilization Management/Review Committee for documentation completeness and compliance with patient status.
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GENERAL FUNCTION The Optometric Technician ensures all patients receive the highest quality Optometric care while receiving an eye exam. BASIC QUALIFICATIONS High School graduate or equivalent 2+ years’ experience in optometry, ophthalmology or healthcare setting Knowledge of optical and medical terminology Understanding and utilization of optical equipment and diagnostic testing (pre-exam testing, pretesting, visual acuity, etc.
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The Case Manager works proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to achieve maximum clinical and financial outcomes.
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Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) The Case Manager is accountable to facilitate the interdisciplinary team to plan, coordinate, implement and evaluate patient care for assigned service line across the continuum of care.
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Posted job title: Supervisor Of Utilization Management, Clinical (Hybrid) About VNS Health VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations.
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Collaborates and educates the medical staff on appropriate utilization review guidelines and documentation in accordance with CMS regulations and Commercial payors guidelines. POSITION SUMMARY:Performs concurrent utilization review activities on all patients within the assigned caseload.
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Knowledge of Utilization Review criteria to include Interqual and/or Milliman. Contacts the Attending Physician to obtain additional clinical information on the case to minimize denials and to assist with reimbursement of care and/or appeals.
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Assists management in developing cost accounting methodology and model to enable NBMC to determine costs of nursing care and other direct costs and to provide information for NBMC planning and decisions (e.g., pertinent elements of patient care, labor, non-labor, and indirect allocation.
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As a Business Office Manager, you will report directly to the operational leader and serve as a key member of care center operations and management team by planning, directing and coordinating the billing, purchasing, human resources, communication systems, space utilization, administrative support and mail services.
$35 - $44 an hourFull-timeExpandApply NowActive JobUpdated 20 days ago
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