…required to have a working knowledge of ICD9, CPT and HCPCS coding and managed care . Responds to incoming telephone calls and (per provider instructions) calls

…provides feedback re: opportunities to improve. Requirements: BSN Preferred 3-5 years acute care /clinical experience; 2-3 years managed care and/or care

…the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers,

…for internal meetings. **Preferred Experience** 3-5 years clinical practice with managed care , hospital nursing or utilization management experience. **Preferred

Nurse Clinician III Out Pt (RN) - Casual...UTMB Health Requisition # 2103627 The mission of Correctional Managed Care is to address the healthcare

…abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care , and private sources, as applicable. Demonstrate extensive advanced

…to internal controls and reporting structure. *May not apply in a correctional managed care environment. **MARGINAL OR PERIODIC JOB FUNCTIONS:** + Performs

… Care Management UTMB Health Requisition # 2405174 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient

…patient assessment skills; good oral and written communication; thorough knowledge of managed care principles, regulatory guidelines (ie, Medicare, Medicaid, and

…is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field