…EXPERIENCE: 1- 2 years experience in a quality management program in a managed care /health plan, IPA, hospital setting(s) preferred Must possess a keen

…the Registered Nurse /Physician, and documents in the patient's record. Documents care given in the Electronic Medical Record (EMR). Safety factors relevant to

…UHG, WellMed, Managed Care , Care Management, Care Operations, RN, Registered Nurse , Medical Management, Utilization Management, Case Management,

…resource management. Maintains knowledge and understanding of CMS regulations, Medicare/Medicaid, managed care and other payer regulations and benefit limits.

…and then, as requested, subsequent re-credentialing applications to insurance carriers and managed care plans on a timely basis. Providers are expected

Overview: Dignity Health is one of the nation's largest health care systems. As of June 30, 2017, Dignity Health operated more than 400 care centers, including

…care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals,

…Qualifications: Bachelor's degree in Nursing 3 years of experience in managed care with significant program management experience Previous wellness/disease

…in care coordination. Comprehensive knowledge of workers' compensation, insurance, and managed care , suggested. Familiarity with long- term care and/or

…surrounding areas Preferred Qualifications: Medical/Behavioral setting experience (ie hospital, managed care organization, or joint medical/behavioral outpatient