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... action taken in the member services department is to facilitate access ... emphasis on member advocacy and patient safety. While this associate receives ... action taken in the member..
... complexity. Responsibilities The Care Coach Coordinator employs a variety of strategies, ... that hinder effective care. Ensures patient is progressing towards desired outcomes ... desired outcomes by continuously monitoring..
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... Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ... (EFMP), auditing for quality and clinical compliance, and case management. Serve ... documentation. Complete required audits of..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of ... codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Coordinator 2 performs varied activities and..
... monitor, and evaluate the medical services required to meet the complex ... self-care, to cost-effectively achieve desired clinical outcomes and to enhance quality ... will serve as the primary..
... Manager, Utilization Management Nursing utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The ... with high value health care..
... The Utilization Management Nurse utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The ... with high value health care..
... care combined with an excellent patient experience. CenterWell Senior Primary Care ... health education and value-added, well-being services at the centers and around ... providing a concierge experience, multidisciplinary..
... care combined with an excellent patient experience. CenterWell Senior Primary Care ... health education and value-added, well-being services at the centers and around ... specialist, quality based coder, referral..
Description The Medical Coding Coordinator 3 extracts clinical information from a variety of ... codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Coordinator 3 performs advanced administrative/operational/customer support..
... to make determinations whether requested services, requested level of care, and/or ... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations,..
Job Information Humana Medical Coding Coordinator 3- Remote USA in Jersey ... Jersey Description The Medical Coding Coordinator 3 extracts clinical information from a variety of ... codes (e.g., ICD-10-CM,..
... and 3) contribute as a clinical industry representative. As a leader, ... background, business acumen, and industry-standard clinical / coding guidance to ensure ... addition, the position provides supportive..
... that medically necessary and appropriate services and supports are in place ... decisions about the appropriateness of services provided by other healthcare professionals ... Medical Director serves as a..
Job Information Humana Nationwide Medicaid Behavioral Health Quality Lead in Jersey City New Jersey Description The Behavioral Health Quality Lead will report directly to the National Medicaid Quality Director, and be ..
... care combined with an excellent patient experience. CenterWell Senior Primary Care ... health education and value-added, well-being services at the centers and around ... Care, is seeking a Care..
... of life and achieve desired clinical outcomes. As part of the ... primary point of contact and coordinator for the beneficiary for all ... for all activities within the..
... MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Jersey ... on medical background and industry-standard clinical / coding guidance to ensure ... MD, Stars and Risk Adjustment..
... care combined with an excellent patient experience. CenterWell Senior Primary Care ... health education and value-added, well-being services at the centers and around ... environment for all. The Referral..
... Director, Utilization Management Nursing utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The ... to grow, the National Medicaid..