A healthcare company has a current position open for a Telecommuting Registered Nurse Telephonic Senior Case Manager. Individual must be able to fulfill the following responsibilities: Recommending services for Plan members.
An insurance company is in need of a Telecommute Vision Provider External Relations Representative. Must be able to: Function as the first point of elevation for provider issue resolution. Manage sophisticated and/or strategic relationships with assigned provider groups.
Be responsible for day to day quality assurance programs, metrics, reports and data of the federal government contract. Be responsible for the interactions and business processes related to the program. Develop strategies and work with client leadership. Skills and Requirements Include:
Must be onsite approximately 35% of the time, as well as, travel to client sites. Bachelor's degree in a related field is required. 5 - 8 years of healthcare experience. Excellent strategic thinking skills and ability to demonstrate value to various key account contacts.
Core Responsibilities of this position include: Support quality program design and implementation for child protection programming from public and private funding streams. Support child protection emergency response teams. Liaise with key partner agencies and donors. Qualifications Include:
Minimum of 5+ years recent auditing experience in a hospital setting. Must have experience in regulatory issues related to Medicare and other third party payers as is relates to hospital coding and billing. Requires RHIA, RHIT and /or CCS.
Utilizing applicable sources of information to identify, assess and enroll patients requiring case management. Assessing, planning, coordinating, implementing, monitoring and evaluating the care of each beneficiary. Coordinating and collaborating with other members of the program.