POSITION SUMMARY/RESPONSIBILITIES
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
...Overview Sales Call Center Agent (Italian-speaking) join a dynamic team at Neo Group on behalf of a partner. This role focuses on engaging customers to introduce and explain products and services, with a commitment to achieving sales targets in a fast-paced environment...
...detailMaintain a clean, safe, and organized work environmentFollow all company safety standards and proceduresQualificationsPrevious upholstery experience (furniture, automotive, marine, or related field)Strong understanding of upholstery tools, techniques, and...
...This role oversees Regional Vice Presidents, Field Leadership Development, and Firm Resource Group teams to turn strategy into... ...philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high...
...Think Academy Online is a leading education technology company dedicated to providing high-quality K12 supplemental learning... ...This Role We are seeking passionate Native-level English-Speaking ELA Content Teachers to join our online teaching team. The ideal candidates...