Conduct in-home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence-based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment Formulate a list of current and past medical conditions using clinical knowledge and judgment and the findings of your assessment Communicate findings in your assessment that will be used to inform …
PT, Nurse Practitioner, HouseCalls – Washoe County, NV
PT Medical Assistant – Pulmonary, Crystal Run Healthcare
Arrives to work on time or notifies Patient Care Manager or designee as soon as employee becomes aware that s/he will be absent or tardy, and/or as per individual department protocol Maintains an acceptable attendance record as per CareMount Medical policies and procedures Notifies Patient Care Manager or designee whenever leaving CareMount Medical premises during scheduled work hours Attends all mandatory CareMount Medical programs and in-services Dresses according to CareMount Medical dress code Assumes responsibility for reading, understanding, and complying …
Provider Representative – San Juan, PR
Manage daily census, close normal delivery cases per Federal Mandate, gather newborn data, and report required data elements Calling providers to verify delivery information and discharge dates, and responding back to providers on a daily basis with authorization numbers Input data (newborn and KICK data elements) and research to gather additional information when necessary Ensure accuracy of FLASH bi monthly. With some Health Plans, this function includes assistance with enrollment of newborns as required
Provider Relations Representative
Accountable for a full range of provider relations including engagement with and development of prospective providers Design and implement strategies to increase the membership of providers in the network Create and execute a marketing plan to build and nurture provider network Identify needs in provider network, incorporating potential gaps related to composition, services, or geographical needs Support leadership in establishing and maintaining strong business relationships with Hospitals, Physicians, Pharmacies and Ancillary providers, and ensure the network composition includes an appropriate …
Provider Relations Manager – Field Based covering Glendale, CA Region
Assist in end-to-end provider claims and help enhance call quality Coach, provide feedback and guide others Assist in efforts to enhance ease of use of physician portal and future services enhancements Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers Help implement training and development of external providers through education programs Identify gaps in network composition and services to assist network contracting and development teams
Provider Relations Advocate – Remote in HI
Assist in end-to-end provider claims and help enhance call quality Coach, provide feedback and guide others Assist in efforts to enhance ease of use of physician portal and future services enhancements Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers Help implement training and development of external providers through education programs Identify gaps in network composition and services to assist network contracting and development teams Work with less structured, more …
Provider Relations Advocate – North Riverside County, CA
Serve as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum’s internal processes and priorities, and other Optum initiatives, as applicable Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to develop action plan for specific metrics needing improvement. Works with office to effectuate action plans and monitors progress Intervenes and escalate issues as appropriate Maintains awareness of providers interested in further engaging …
Provider Network Access Specialist – Remote in New Mexico
Confirm contract compliance specifics to meet the needs Turquoise Care contract network standards Work with cross-functional teams within UnitedHealthcare to strengthen provider networks across multiple functions including but not limited to behavioral health, physical health, dental and vision Conduct advocacy activities with targeted providers to solicit participation Work with internal groups to identify, understand, and / or improve internal tools, resources, systems, and capabilities that can maximize provider and member experience Analyze data to determine root cause of issue (e.g., …
Provider Enrollment Specialist
Process provider applications and revalidation applications through verifications, credentialing, and site visits Accurately input enrollment data into database system Conduct quality assurance functions to reduce errors and improve processes and performance Demonstrate great depth of knowledge / skills in own function and act as a technical resource to others Educate and provide training to Providers on billing, prior authorization, and other administrative functions Investigate non-standard requests and problems