…knowledge of additional payer types including but not limited to insurance carriers, managed care organizations and affordable care organizations. *

…we touch. Milwaukie is also a contracted providerfor Medicaid, Medicare and several managed care plans.Build Your Healthcare Career with Prestige CarePrestige

…of nursing experience, including two (2) years of utilization review/case management, managed care or comparable patient payment processing experience. Knowledge

…and Milliman criteria. Represents facility providing formal appeals via letter and phone to managed care payers. Appeal processes include but are not limited to

…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

…councils to achieve departmental and organizational goals and objectives. Provides nursing care as needed. The Manager, Nursing Registered Nurse (RN) 1

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

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

…function requirements as needed based on the requirements of the practice and of managed care payors and insurers. Qualifies for malpractice insurance and is

…cohesively with team, members, physicians and medical staff to articulate complex concepts in managed care and coordinated care principles + The ability to