…utilization management experience in the acute, sub-acute, home health setting or managed care environment. **Why Join Providence?** Our best-in-class benefits

…and managed in an effective manner with friendly customer service. As the Care Management Services Registered Nurse , you will provide care management and

…payor within the patient population; 2. Provides the clinical information requested by the managed care companies as part of the concurrent review in a timely

…Experience with electronic medical record preferred + Minimum of 1-3 years' floor nurse experience in skilled nursing, long-term care , assisted living or

…application of positive language principles + Knowledge of Medicare, Medicaid and Managed Care requirements + Progressive knowledge of community resources,

…with front desk for check-in, check-out and phone coverage. + Assist in co- managed care collaboration with non-VA providers, and facilities. + Provide patient

…do not have MSW, MA or MS degree + 3 years of relevant experience managed care and/or case management experience Preferred + Strong knowledge of management

…of terminally ill patients and their families. + Thorough knowledge of managed care principles, regulatory guidelines (ie, Medicare, Medicaid, JCAHO, ACHC,

…an understanding of MDS requirements related to varied payers including Medicare, Managed Care and Medicaid + Ensures timely electronic submission of

…pertinent to patient service and billing procedures: including basic knowledge of all managed care plans and which insurers require a copayment or referral.