Conducts medical home visits on established Bridges in Complex Care patients performing a hands on exam at each visit Conducts urgent / acute visits on established Bridges in Complex Care patients with the goal of keeping the patient out of the hospital in order to receive the best medical care at home Provides ongoing assessments of the impact of life limiting chronic il

Performs all duties within the scope of a Medical Assistant's practice. Operates diagnostic equipment (cannot interpret tests), remove staples from superficial wounds, changes wound dressing and obtains cultures, administers non intravenous medication, performs simple specimen collection via noninvasive techniques and collects blood specimens via venipuncture or via capil

Independently collaborates effectively with Interdisciplinary care team (ICT) to establish an individualized transition plan for members Independently serves as the clinical liaison with hospital, clinical and administrative staff as well as performs a review for clinical authorizations for inpatient care utilizing evidenced based criteria within our documentation system

Create, control and improve end to end business processes Lead process design and project implementation teams in process improvement activities Create quality reporting, analysis and audits for developing plans and programs to support continuous quality improvement using applicable tools Assist in the creation, implementation and evaluation of Total Quality Management (T

Performs all nursing duties within the scope of a Licensed Vocational/Practical Nurse (procedures, injections, medication administration, EKGs, phlebotomy) as determined by the applicable State Board of Nursing Participates in implementing established education plans for patients and their families with common health problems and well defined health learning needs Coordin

Performs all duties within the scope of a Medical Assistant's practice. Operates diagnostic equipment (cannot interpret tests), remove staples from superficial wounds, changes wound dressing and obtains cultures, administers non intravenous medication, performs simple specimen collection via noninvasive techniques and collects blood specimens via venipuncture or via capil

Greets patients as they arrive and manage appropriate standard wait times Complete check in and check out tasks to include insurance verification, complete pre authorizations and/or precertification of procedures, and copy required documents Collects co payments, co insurance, and deductibles and issues receipts Manages cashier box and daily deposits according to company

Receives and responds to escalated pharmacy inquiries from all communication venues e.g. phone queue, portal, claim queue, department e mail box or fax Coordinates and assists initial screening of MAP enrollment requests via all communication venues; as well as administrative preparation for clinical staff Conducts in bound and out bound calls for program requirements inc

Provide expertise and support by conducting audits across several departments, including call, claim, eligibility, intake and system configuration Provide feedback and reports to team members on audit results Analyze information to build recommendations to reduce errors and improve process performance Responsible for all aspects of quality assurance This role is equally c

Performs all nursing duties within the scope of a Licensed Vocational/Practical Nurse (procedures, injections, medication administration, EKGs, phlebotomy) as determined by the applicable State Board of Nursing Participates in implementing established education plans for patients and their families with common health problems and well defined health learning needs Coordin

Provide claims expertise support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities Analyze, identify trends and provide reports as necessary Ensure adherence to state and federal compliance policies, reimbursement policies and contract c

Answer 35 50 incoming phone calls per day from customers and identify the type of assistance the customer needs. Ask appropriate questions and demonstrate active listening to identify specific questions or issues, build rapport, respond with compassion while documenting required information in computer systems. Research complex issues across multiple databases and work wi

Responsible for data entry of material from source documents to a computer connected terminal May operate an alphabetical / numerical keypunch machine Verifies data and performs clerical tasks in the data processing function Examines, revises, approves and dispatches input and output materials according to established specifications Works on assignments that are semi rout

Performs all duties within the scope of a Medical Assistant's practice. Operates diagnostic equipment (cannot interpret tests), remove staples from superficial wounds, changes wound dressing and obtains cultures, administers non intravenous medication, performs simple specimen collection via noninvasive techniques and collects blood specimens via venipuncture or via capil

Works with the providers and clinic staff to identify patients with chronic disease diagnoses Supports longitudinal care of the patient with stable chronic care conditions by Performing focused assessment of chronic care conditions Performing medication reconciliation Conducting Motivational Interviewing and Self Management Goal setting Providing patient education using s