A healthcare company is seeking a Telecommuting Senior Case Manager Registered Nurse. Core Responsibilities of this position include: Managing network participation, care with specialty networks, care with DME providers and transfers. Recommending services for Plan members.
A healthcare company has an open position for a Telecommute Registered Nurse Quality Letter Reviewer. Core Responsibilities of this position include: Coordinating internal reviews on denial letters. Performing internal Quality Control reviews on processes and activities.
A healthcare corporation is searching for a person to fill their position for a Telecommute Clinical Appeals Nurse in Orange Park. Candidates will be responsible for the following: Composing clinical appeal letters to send to payers for denial reconsiderations.
Applicants must meet the following qualifications: Ability to travel. 5+ yrs. experience as Data Manager (or proven managerial experience) Medical/Nursing, Life Science/Mathematical Degree or relevant experience.
Must be willing and able to commute to multiple Skilled Nursing facilities in Dupage County. Minimum of 3 years total RN experience including experience in acute long term care, acute rehabilitation, and/or skilled nursing facilities. Must have a designated quiet workspace in your home.
A healthcare company has a current position open for a Telecommute Registered Nurse Clinical Services Trainer. Candidates will be responsible for the following: Ensuring healthcare services staff understand professional standards of documentation.
BA/BS degree in the science/health care field or nursing degree, or equivalent. Extensive understanding of SOPs, Work Instructions (WI), FDA, and local regulations. Moderate independent field monitoring experience. Minimal lead monitoring or comparable supervisory experience.
A health insurance company is seeking a Telecommute Telephonic Nurse 2 Care Manager. Individual must be able to fulfill the following responsibilities: Ensure patient is progressing towards desired outcomes. Identify and resolve barriers that hinder effective care. Create member care plans.
Current accreditation by the American Academy of Professional Coders (AAPC) or American Medical Record Association (AHIMA) Ability to maintain a 95% coding accuracy rate. Effective oral and written communication skills are required to work with medical, nursing, and other allied health staff.
Graduate degree in nursing, data science, business, healthcare admin, engineering or related. Experience in consulting, health plan, care delivery, or health care technology or services. 5 years of experience or leadership in value-based care leadership or related roles.