…matrixed organization. Maintains a depth and breadth of clinical competency and/or managed care knowledge to assess outcomes, provide oversight and coordination

…medication review for polypharmacy, recent hospital or emergency department discharges, and co- managed care patients. VI. Functions as a mid-level provider to

…and coordination of the RAI process. Provides Medicare, Medicaid (case mix), and managed care oversight to ensure appropriate clinical services are provided and

…policies of the practice to include: (1) Purchasing and capital allocations; (2) Managed care plan participation; (3) Budget and practice expenses; (4)

…required to have a working knowledge of ICD9, CPT and HCPCS coding and managed care . Responds to incoming telephone calls and (per provider instructions) calls

…experience preferredPrevious management experience in a union environment preferredPrior managed care or integrated delivery systems experience

…the nation's leading provider of healthcare services, a company comprised of locally managed facilities that includes 166 hospitals and 114 outpatient centers in 20

…patient care . Five to ten years of experience in the managed care environment which includes significant involvement with utilization/quality issues.

…at a level of related experience in Quality Assurance, Safety, or Managed Care , preferred EXPERIENCE: Three years management experience and Quality/Patient

…Advanced Beneficiary Notice Form, Medically Necessity requirement through Medicare and Managed care providers, and scheduling protocols.All Employees are