In this role, the selected candidate will be responsible to monitor inpatient and intermediate level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
In this role, you will be responsible for
conducting sales calls with eye doctors (optometrists, ophthalmologists) and other optical specialists to promote our contact lenses and contact lens solutions using consultative selling approach.
In this role, the selected candidate will manage a diverse HEDIS team, including clinical and non-clinical project managers, consultants, analysts and outreach coordinators, encourage staff development, provide oversight of performance metrics and ensure compliance with all HR policies and procedures.
In this role, you will ensure the safe transition of patients thru the continuum of care to include active participation of nursing staff in planning and coordinating patient care, and direct hand-off to next appropriate level of care.
The Care Manager is responsible for providing care management services to beneficiaries with admissions to acute care hospitals, or to transition of care from non-par to par facilities, ensuring continuity of care.
The selected candidate will coordinate with the health care team and the patient/family to address payer issues that impact care, and to develop a transition plan of care that includes a safe discharge plan and plan for follow up with care providers post discharge.