Must be able to: Design, develop, implement, and evaluate state-of-the-art Electronic Medical Records (EMR) efficiencies. Develop and provide quality improvement and training activities which are designed to improve the user end performance.
Individual must be able to fulfill the following responsibilities: Overseeing the care of these patients, attend medical appointments, visit hospitals, coordinate medical equipment and home modifications. Facilitating and coordinating all aspects of Medical and Non-Medical care.
Solid knowledge of multiple product lines of medical case management and/or utilization review and/or clinical consultation. 6 years related experience to include 3 years case management experience required. Knowledge of statutory requirements of different state jurisdictions.
Core Responsibilities Include: Conducting medical management activities. Representing the company before client management, members, and physicians. Performing care coordination, and performing assessments to create a care plan. Qualifications for this position include:
Collaborating with other health care givers in reviewing actual and proposed medical care and services. Managing network participation, care with specialty networks, care with DME providers, and transfers to alternative levels of care. Applicants must meet the following qualifications: