… and medical necessity according to criteria established by TMF, Medicare, Medicaid, Managed Care agencies, and Clinical Path resources [Interqual, M&R]. Such

…restrictions 2+ years' preferred experience in Utilization Management, Case Management or Managed Care 3+ years clinical experience Working knowledge of Windows

…with Providers as needed, responds to provider questions with regard to EAP or Managed Care cases. * Performs provider recruiting duties as needed. * Serves

…delivery of patient care services, including but not limited to Medicare, Managed care , Medicaid, third party providers, challenges to current health care

…inquiries, and outcomes EDUCATION/EXPERIENCE: Requires 1-2 years experience with an understanding of managed care or Medicare or any combination of education and

…plan while maintaining documented assessments in compliance with DCF, CARF and Managed Care requirements and make themselves to on-call responsibility as

…delivery of patient care services, including but not limited to Medicare, Managed care , Medicaid, third party providers, challenges to current health care

…quality home health care to adult and geriatric Veteran, Medicare, Medicaid and Managed Care patients in their homes and in the community. The Nurse Case

…to be the liaison role between facility and psychiatrist Excellent computer skills Prior managed care experience is good but not required Why Apply: Full

…continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are