Supports continuum of member care by identifying members in need of health education, case management, etc.
Supports quality improvement program studies by conducting member and provider education and outreach, requesting records from providers, maintaining databases, and conducting research to identify members' provider encounter history.
ESSENTIAL JOB RESULTS:
Coordinates and performs medical record reviews to determine compliance with quality metrics, service delivery, and quality ...
Provides Utilization Review services for clients including telephonic review, clinical case review, timely response to insurance requests for information and accurate documentation of case work.
Essential Duties and Responsibilities:
Duties may include but are not limited to the following:
• Gathering clinical information from client’s record.
• Timely telephonic review with insurance companies.
• Communication with treatment team regarding insurance needs, length of stay and other information as ...
Our client has several positions open and is seeking an individual who enjoys working with the senior population. These are immediate direct hire.
This Case Manager will strategically manage services for specified patient populations. They will provide a focus on wellness, prevention, and efficient care through the coordination with their patients, their patient’s families and their physicians. The education of the patient and his/her family will be incorporated into the care plan after careful ...
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