…the ages of 21-64 years of age. You will work on a small, collaborative team with One Care Nurse Care Managers and other Care Coordinators as well as our

…settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience with InterQual or Milliman Guidelines.

… care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral

…working with developmental disabilities population + Medicare and Medicaid experience + Managed care experience **SKILLS** + Working flexible hours to meet

…diagnostic & treatment clinic preferred. + Customer Service experience is required. + Managed long-term care insurance experience beneficial. + Minimum of one

…the VA and works with these patients utilizing rules set forth by the VA for co- managed care . + Completes any and all clinical reminders "due" at the time of

…tracking Medicare days in the facility. + Serves as facility contact with Managed Care providers to ensure appropriate authorization and reimbursement for

…a hard-working and dedicated Referral Coordinator, to prepare and process all managed care referral paperwork, schedules and pre-registers patients for exams

…model + Discharge Planning Experience + Motivational Interviewing skills + Managed Care /Utilization Review Experience + Clinical experience and demonstrated

…clinical acumen and the appropriate application of policies and guidelines to Managed Care prior authorization referral requests. Under general supervision this