Focus on initial inpatient admission for psychiatric and chemical dependency patients. Make patient assessments and determining appropriate levels of care. Manage inpatient mental health cases throughout the entire treatment plan. Applicants must meet the following qualifications:
Fostering dialogue between patient and healthcare provider. Coordinating the connection between patients and program approved. Applicants must meet the following qualifications: Travel up to 20% Valid driver's license required. 5 yrs. clinical experience in healthcare.
A non-profit healthcare company is searching for a person to fill their position for a Remote Home Health Quality Assurance Reviewer. Must be able to: Coordinate, monitor, and audit documentation and coding of home health and hospice. Analyze audit results.
3 years in a hospital or acute care setting with multidisciplinary service lines. Registered Health Information Administrator, Registered Health Information Technician, OR Certified Coding Specialist credential. Computer software skills with MS Office products, Word and Excel.
Interpret criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Skills and Requirements Include: Active RN license without restrictions. Previous experience in utilization management.
Gather clinical information to assess and expedite care needs. Qualifications Include: Proficient with Microsoft Word to create, edit, save and send documents. Current, unrestricted RN license in the state of residence. 3 years recent hands on clinical experience.
Reviewing, interpreting and recommending Plan of Care corrections as needed. Applicants must meet the following qualifications: Must be a Registered Nurse or DPT with home health and/or hospice experience. At least one year of coding experience.
Have an ASN/BSN. Willing to apply for any state licensure the organization requests. 1 year of experience in a Managed care organization (MCO) or Third party administrator (TPA) Become knowledgeable of URAC requirements for CM accreditation. Have reliable high-speed internet service at home.
Perform care management within the scope of licensure for members. Ensure member access to services appropriate to their health needs. Position Requirements Include: Must live within 60 miles or 1 hour of local office. 3 years of clinical RN experience. BA/BS in a health related field.
Prior clinical experience in an acute care, skilled or rehabilitation clinical setting. Experience with quality improvement processes pertaining to Medicare guidelines. Excellent computer skills and ability to easily navigate multiple applications.