A health insurance company has a current position open for a Remote Care Management Support Nurse. Core Responsibilities Include: Transitioning patients from skilled nursing to the home setting. Making decisions on moderately complex to complex issues.
Provide operational leadership support and assigned market leadership teams. Provide clinical and system training to new employees and refresher training to current employees. Assist with strategy and process development, and implementation, including measurement of outcomes.
Providing members with tools and educational support. Recruiting and enrolling members into the Disease and/or Maternity Management Programs. Identifying member health risks and utilization patterns to plan proactive interventions. Applicants must meet the following qualifications:
Support clinical staff through the completion of components of case management. Position Requirements Include: Professional demeanor with excellent written and oral communication skills. Valid state LVN license in good standing with no restriction. Strong organization skills.
Help support a national digital health solutions organization. Qualifications for this position include: 50-50 remote work vs on-site and travel within 30-minute radius of DC. 3+ years clinical RN experience. Case/Care management experience with multiple concurrent accounts/cases.
A healthcare company is filling a position for a Telecommute Clinical Operations Support Specialist in Orlando. Must be able to: Ensure knowledge transfer and best-practice sharing to sites. Communicate processes, policies, and corporate vision effectively.
Core Responsibilities Include: Reviewing Provider request for supporting documentation. Requesting additional documentation. Ensuring regulatory guidelines are met. Position Requirements Include: Unrestricted Registered Nurse (RN), LPN or LVN license required for the state of employment.
A company that supports the program integrity efforts of federal and state government programs is searching for a person to fill their position for a Telecommute Medical Review Nurse. Candidates will be responsible for the following: Engaging in medical review tasks. Other duties as assigned.
Making clinical determinations for payment supporting claims submitted to Medicare. Assessing and ensuring services/items billed are reasonable and necessary. Adapting to a wide variety of medical review topics and multiple Medicare lines of business. Qualifications for this position include:
Providing support to care coordinators. Position Requirements Include: 1+ years of experience working directly with individuals who meet the MLTSS target population. Demonstrated ability to communicate with members who have complex medical needs.