…certification. RI RN license and license for prescribing privileges. Knowledge of managed care process. Experience and licensure to be credentialed required.

Responsible for utilizing clinical acumen and managed care expertise related to researching, resolving and responding to requests for member and provider

…for health plans. Our services help Medicare Advantage, Commercial/Exchange, and Medicaid managed care plans improve and support accurate reimbursement in a

…will: Functions as a liaison for management staff, administration, physicians, managed care companies, community organizations, and other customers. Coordinates

…management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical

…other government contractors will be for the sole purpose of coordinating patient care . Contract nurse practitioners providing services under this contract shall

Registered Nurse (RN) MDS Coordinator Carlton Shores Health and Rehabilitation, a 114 bed rehab facility, has a fabulous opportunity for a business savvy Registered

…of specialty. 3. Knowledge of utilization review, discharge planning, clinical pathways, managed care and “Best Practice Guidelines” preferred. 4. Experience in

…. JOB DESCRIPTION: The Clinical Supervisor is responsible for ensuring that patient care is coordinated and managed appropriately. The Clinical Supervisor is

…Full-Time Reports to: Lead Supervisor Start Date: Immediately Position Summary My Choice Family Care is a leading managed care organization serving 26