Providing program orientation to new participants. Assisting participants in identifying personal outcomes. Qualifications Include: Ability to attend monthly meetings and travel as needed. Bachelors degree in related field or 4 years' relevant experience. Knowledge of Long Term Care programs.
Reviewing health care services. Assisting with program processes for transition. Providing information to enrollees, providers, and internal staff. Skills and Requirements Include: 5+ years experience conducting utilization management. Registered Nurse, FL Licensure.
Must meet the following requirements for consideration: Experience in long-term care, home health, hospice, public health or assisted living. 3 years of experience working within the community health setting in a health care role. 2 years of experience working with MS Word, Excel and Outlook.
A healthcare company is filling a position for a Telecommute Clinical Services Assistant II in Latham. Core Responsibilities Include: Recording and managing member inquiries. Reviewing work queues daily as needed. Making survey calls to members and records responses.
Assist in problem solving with providers, claims or service issues. Skills and Requirements Include: Ability to go to office for training, technical computer issues, or business needs. Current, unrestricted RN license. Knowledge and work experience with Microsoft Office (Excel and Outlook)
Assisting claim handlers in managing medical treatment to an appropriate resolution. Contacting medical provider and employees on claims involving medical treatment and/or disability. Required Skills: Must have RN License. Disability Case Management experience.
Contributing to the case management process. Assisting members with scheduling appointments and locating physicians. Assisting in determining the physical and mental health status. Position Requirements Include: Ability to travel locally (minimal) within an assigned area is required.
Assisting the Federal Staff in providing training/technical assistance. Participating in case reviews with facility staff on a weekly basis. Providing thorough case management. Position Requirements Include: Requiring travel within the Philadelphia area.
Assist in the development and implementation of various programs. Address gaps in care, medication adherence and perform medication reconciliation. Applicants must meet the following qualifications: Travel required (0% - 25%) Registered Pharmacist.
Conduct an evaluation of member's needs and benefit plan eligibility. Assess the need for a referral to clinical resources for assistance in determining functionality. Required Skills: 0-10% travel. RN licensure required. 5+ years clinical practice experience required.