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Collaborates effectively with interdisciplinary team (IDT) to establish an individualized plan of care for members, goals including both short and long term Works with the Utilization Management (UM) RNs, Social Worker (LMSWs) Care Managers and other internal and external providers to facilitate smooth care transitions Serves as the primary clinical liaison with hospital, clinical and administrati
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Act as the subject matter expert in all areas of patient scheduling and access Coordinate and supervise daily/weekly/monthly activities of team members Set priorities for the team to ensure task completion and performance goals are met Coordinate work activities with other supervisors, managers, departments, etc. Provide feedback for annual performance reviews and formal corrective action Ass
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divvyDOSE is a new kind of home delivery pharmacy in a hyper growth phase focused on adherence packaging. Our company is professional but fun, dedicated yet quirky. We are fast paced, highly motivated doctors, pharmacists, pharmacy technicians, and support staff who focus on health and wellness (and if we’re being honest, sometimes pizza) and most of us have slight obsessions with our pets.
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The NP or PA is expected to be able to provide care consistent with their licensure and/or certification Diagnoses and treats both acute and chronic conditions such as diabetes, hypertension, kidney disease and other chronic medical conditions. The NP or PA will also treat acute conditions such as minor injuries and other acute medical conditions such as infections or exacerbations of chronic dise
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Manage unit cost budgets, target setting, performance reporting and associated financial models Experience working with different provider types such as Hospitals, Ancillary, and Medical Group Providers Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management Evaluate and negotiate contracts in complian
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Research and resolve written complaints submitted by consumers and physicians/providers Ensure complaint has been categorized correctly Obtain additional documentation required for case review Review case to determine if review by clinician is required Render decision for non clinical complaints using sound, fact based decision making Complete necessary documentation of final appeals or grievance
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Application design and development based on business requirements in tools such as DBeaver, DB Visualizer, Spark SQL etc. Responsible for the gathering of requirements, analysis, design, and implementation of high quality code product with a focus on software as a service solutions. Ability to write SQL queries and perform table joins, and complex data merges Support systematic reporting processes
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Data entry of billing mnemonics and all required billing information that appears on imaged requisitions Maintain Compliance and HIPAA regulations at all times Ability to work in a fast paced environment and multi task Ability to meet quality and production standards Must be detail oriented with independent work habits You’ll be rewarded and recognized for your performance in an environment
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Provide holistic family support to members who may have special needs themselves or may be caring for children or family members with special needs, owning end to end resolution of issues. Serve as an ongoing, point of contact for members, primarily via the phone channel (may also will use email, chat, text), delivering compassionate support to members, creating a memorable, positive experience. C
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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm) The Medical Assistant (MA) participates in providing patient care at the appropriate skill level. They have a duty to provide a standard of care that meets or exceeds that of a reasona
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Manage unit cost budgets, target setting, performance reporting and associated financial models Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance, trend management and appropriate distribution of provider specialties Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards
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Build and execute the clinical policies and strategy within regional markets. Bring together stakeholders across multiple clinical settings and levels of care to deliver efficient and well coordinated behavioral health treatment. Intervene as indicated to ensure that patients receive timely, high quality, and coordinated care. Conduct analyses, review reports, and track any trends related to healt
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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm) The Medical Assistant (MA) participates in providing patient care at the appropriate skill level. They have a duty to provide a standard of care that meets or exceeds that of a reasona
Posted Today
Partner with business leaders to drive strategy, establish financial targets, and develop options and solutions to enable Pharmacy Care Services business growth including growth of specialty, Home Delivery & Consumer oriented business models Lead cross functional team and pharmacy care services P&L owners in planning, enabling Optum to leverage our scale while providing for needed capabili
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Lead Labor Administration Collaborate with Finance on workforce administration Reconciliation of labor / payroll records T&E Management and reporting Lead a team of accountants Develop, implement and maintain processes and procedures for accurate and timely analysis of financial data, ensuring best practices Develop and maintain internal control structure and procedures for time and expense r
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