Must be able to: Review clinical assessments and determining appropriate levels of care. Determine if additional clinical services are needed. Coordinate benefits and transitions between various areas of care. Qualifications Include:
Performing concurrent reviews for inpatient and/or outpatient care. Qualifications for this position include: Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care.
One of the most diversified healthcare companies needs applicants for an opening for a Telecommuting 3rd Shift Licensed Mental Health Care Advocate. Core Responsibilities of this position include: Obtaining information from providers on outpatient requests for treatment.
A managed care company has a current position open for a Telecommute RN Transition Care Coach in the Spartanburg Area. Individual must be able to fulfill the following responsibilities: Coordinate care and reassess member's needs.
Assessing and reviewing plan of care to identify gaps in care, trends to improve health and quality of life outcomes. Providing care coordination to members with behavioral health conditions identified and requiring intensive interventions and oversight.
Identify potentially unnecessary services and care delivery settings, and recommend alternatives. Manage network participation, care with specialty networks, care with DME providers. Skills and Requirements Include: 50% Travel required. Prior clinical experience.
Meet with the individual and his/her guardian or care provider. Work with the company's team to ensure completion of all requirements of the program. Skills and Requirements Include: Travel up to 20% - 30% of the time. A Licensed Practical Nurse with at least 3 years’ experience.
Coordinating care for members ranging from low acuity to catastrophic. Coordinating appropriate care to members from admittance to discharge. Performing telephonic medical records review for commercial and Medicare members. Applicants must meet the following qualifications:
A healthcare and health insurance company has a current position open for a Telecommuting Utilization Management Licensed Practical Nurse. Core Responsibilities Include: Participate in fair hearings including preparation of justification and evaluation of service determination.
Work on clinical operations across the continuum of care. Take lead role in setting direction and participating in or developing new programs. Set team direction, resolve problems and provide guidance to members of the team. Must meet the following requirements for consideration: