... other hospital departments, external service organizations, agencies, and health care facilities. Conducts concurrent medical record review using ... advocate, investigates, and reports adverse occurrences, performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery. Education: Bachelor's degree in clinical area preferred. Licenses/Certification: Healthcare professional licensure required; that is, as Registered Nurse, LPN, Respiratory Therapist, Physical Therapist, Occupational Therapist or ...

... outcomes. POSITION QUALIFICATION REQUIREMENTS: Knowledge/Experience: Equivalent to nursing education, master’s degree preferred plus 3 – 5 years ... related specialty area. 1 – 3 years community health experience and/or work in an HMO or managed care environment. ...

... Type: Full-Time Industry: Managed Care Insurance Healthcare - Health Services Manages Others: Not Specified Job Type: Nurse Health Care Insurance Required Education: Not Specified Required Experience: Not Specified Required Travel: ... Available Email: Send Email Now Fax: Not Available Nurse Medical Mgt I or II 42774 Myers Report It Job Description WellPoint in the nation's leading health benefits company serving the needs of approximately 28 ...

... Employee Type: Full-Time Industry: Managed Care Healthcare - Health Services Insurance Manages Others: Not Specified Job Type: Health Care Nurse Insurance Required Education: Not Specified Required Experience: Not Specified Required Travel: ... It Job Description WellPoint in the nation's leading health benefits company serving the needs of approximately 28 ... medical members nationwide. WellPoint is the nation's leading health benefits company. At WellPoint, we are dedicated to ...

... Employee Type: Full-Time Industry: Managed Care Healthcare - Health Services Manages Others: Not Specified Job Type: Nurse Health Care Insurance Required Education: Not Specified Required Experience: Not Specified Required Travel: ... It Job Description WellPoint in the nation's leading health benefits company serving the needs of approximately 28 ...

... other hospital departments, external service organizations, agencies, and health care facilities. Conducts concurrent medical record review using ... advocate, investigates, and reports adverse occurrences, performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery. Abe Ghebrehiwet Senior ...

... elimination of perceived/actual barriers, impact quality of Member’s health, effective use of healthcare resources and promotion of member satisfaction. Collaboration with Health Care Providers to assess, plan, implement, coordinate, monitor, and evaluate services and outcomes to maximize the health of Care Management Members. The coordination of internal ... are considered at risk for adverse outcomes and/or health care condition would benefit from the Care Management ...

... Other Pay: Employee Type: Full-Time Industry: Healthcare - Health Services Insurance Managed Care Manages Others: Yes Job Type: Health Care Insurance Nurse Req'd Education: 4 Year Degree Req'd Experience: At least 5 ... Aetna is ONE of the nation?s leading diversified health care benefits companies, serving members with information and ... help them make better informed decisions about their health care. Aetna offers a broad range of traditional ...

Registered Nurse OUR MISSION: HEALTH CARE FOR ALL NEW YORKERS AND A SUCCESSFUL ... opportunities for talented professionals to join our team. Nurse Case Manager The RN Case Manager works with ... appropriate for the particular member; assesses the Member’s health status and the appropriateness of the indicated treatment ... as the Member’s advocate as necessary; and provides education to patients, families, physicians, caregivers and facilities as ...

... contracts. Responsible for contract development, business maintenance, product/service education, and identification of potential global A/R collection/resolution opportunities. Make face to face calls to Nurse Case Managers, Claims Managers, Claims Supervisors, Claims Adjusters, Occupational Health Nurses, Risk Managers and others who represent the ... Self Administered Employers (SISAs) Preferred Provider Organizations (PPOs) Health Maintenance Organizations (HMOs) Bill Review/Utilization Review (UR) organizations ...