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

…3 to 4 shifts per week. Minimum Requirements: + Master's prepared Acute Care Nurse Practitioner or Physician Assistant + Pennsylvania licensure and certification

Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Occasional travel as needed Covenant Medical Group

…to the hospital. Must be able to navigate through a wide variety of managed care contractual issues. Must have knowledge of and familiarity with Interqual

…guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities

…mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care

…cooperation with emergency department personnel, psychiatrists, clinicians, attending physicians and managed care representatives. While in this position you

…guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**

…for each person served. + Maintains a functional understanding of funding, managed care requirements, and licensing requirements for each person served.

…Job Category Nurse The Clinical Supervisor is responsible for ensuring patient care is coordinated and managed appropriately as well as the supervision of