In this role, you will work with patients/families/caregivers and the interdisciplinary team to enable patients to progress towards care goals and be prepared for timely transition to the appropriate level of care in the community.
In this role, you will perform electronic review of prior authorization requests for appropriate care, following clinical guidelines, policies, eoc and benefit policy and approves services or forwards requests to a medical director for review.
In this role, the selected candidate will be responsible for the development and management of staff and processes to support high-quality, multidisciplinary and family-centered care across the continuum.
In this role, you will provide across-the-continuum, customized care coordination services and management of transitions of care for the most medically fragile Providence Health Plan (PHP) Medicare Advantage, at-risk patients, and their families/caregivers.
In this role, you will perform telephonic care review and authorization determinations for prospective, concurrent and discharge review with psychiatric and substance use treatment facilities as assigned.
In this role, you will perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
In this role you will plan and implement product in-service programs for convatec products. Analyze territorial sales to target key customers for in-service programs. Report results of in-service program to the regional sales manager.
In this position, you will work with patients/families, physicians, nurses, social workers, and other health team members to enable each patient to progress towards care goals and be prepared for timely discharge or transfer.
In this role, you will participate in the development of a written plan of care for each resident and review residents medical and nursing treatments to ensure they are in accordance with the residents care plan and wishes.