…the elders as a Certified Nurse Aide while maintaining standards of Nursing Care . You will work within a self- managed team to provide a home-like atmosphere

…experience as Clinical Social Worker. Basic understanding of Medicare, Medicaid and managed care . Discharge planning or home health background.Excellent verbal

…knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization Review, levels of

…management, case management or quality assurance preferred + Previous experience in a managed care setting desirable + Requires an individual with highly

…discharge planning, utilization management, care management, performance improvement and managed care reimbursement + Knowledge of state and federal

…Option Care . Description of available services is accurate. Meets with managed care organizations and other accounts to facilitate education regarding

…treatment and services. 7. Using CHA approved protocols for telephone triage, the ambulatory care nurse determines the urgency and disposition based on data in

…Grievance and Appeals or related area such as medical or utilization management in a Managed Care setting required + Experience in a supervisory role preferred +

…include the electronic health record. + Monitor and maintain records related to the 29I managed care requirements for Foster Care , Residential Care and

…Days:** 8 hr,variable start time,occ holiday and weekend **Category:** Licensed Practical Nurse **Department:** Revere Primary Care **Job Type:** Full time