…physician and the hospice Medical Director to ensure every patient's symptoms are well managed . * Plan of Care : Evaluate the treatment and medical condition of

Licensed Practical Nurse - LPN - Skilled Nursing Facility Invest in your future by discovering a facility in Kennebunk, ME with resources, technology, and

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

…variety of acute or chronic health problems, often with multiple comorbidities to be managed . The unit also provides inpatient hospice care . There is an emphasis

…States. + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly preferred.

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

… care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral

…Patient Care UTMB Health Requisition # 2406333 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient populations

…mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and

…or UM Certification preferred + Able to apply clinical guidelines to ensure progression of care . + Knowledge of managed care and payer environment preferred.