Conducts training and education programs for providers, clinic staff, administrative departments, physician partners, and vendors as assigned Participates in a team that designs, manages, and implements staff development, medical management, and clinical staff competency programs incorporating appropriate adult learning principles Leverages creativity and utilizes a wide

Independently collaborates effectively with Interdisciplinary care team (ICT) to establish an individualized transition plan for members Independently serves as the clinical liaison with hospital, clinical and administrative staff as well as performs a review for clinical authorizations for inpatient care utilizing evidenced based criteria within our documentation system

Performs all duties within the scope of a Medical Assistant's practice. Operates diagnostic equipment (cannot interpret tests), remove staples from superficial wounds, changes wound dressing and obtains cultures, administers non intravenous medication, performs simple specimen collection via noninvasive techniques and collects blood specimens via venipuncture or via capil

Assisting in the review of medical records to highlight Star/HEDIS opportunities for the medical staff Review medical records for data collection, data entry, and quality monitoring including health plan/WellMed form submission and chart collection activities that close gaps in care Partner with the leadership team, the practice administrative or clinical staff to identif

Performs all duties at the expert level within the Phlebotomist scope of practice Requires little assistance with standard and non standard requests and solves routine problems independently Conducts clinic assessments for compliance with state and federal health care requirements, and PHSA Oversees remediation and corrective action plans, resulting from internal assessme

Greets patients as they arrive and manages wait time Complete check in and check out tasks to include insurance verification, complete pre authorizations and/or precertification of procedures, and copy required documents Collects co payments, co insurance, and deductibles and issues receipts Manages cashier box and daily deposits according to company policies Processes wa

Performs all nursing duties within the scope of a Licensed Vocational/Practical Nurse (procedures, injections, medication administration, EKGs, phlebotomy) as determined by the applicable State Board of Nursing Participates in implementing established education plans for patients and their families with common health problems and well defined health learning needs Coordin

Patient Care Completes an initial assessment of patient and family to determine home care needs. Provides a complete physical assessment and history of current and previous illnesses Regularly re evaluate patient nursing needs Uses health assessment data to determine nursing diagnosis Initiates and develops a Plan of Care, which establishes goals based on nursing diagnosi

Role will split time between telephonic patient outreach to complete assessment and provider facing activities (virtual and in person) working with market representatives Develop market business plans to motivate providers and large or complex group leadership to engage in improving Stars measures to be 4 STARS or higher for pharmacy related measure for Statin Use in Pati

Engages members primarily face to face or over the phone to discuss their health Create a positive experience and relationship with the member Proactively engage the member to manage their own health and healthcare decisions Support the member to improve their well being by staying out of the hospital, and attend regular visits to their primary physician, via education, c

Assist customers with payment processing, invoice explanation, payment due dates and billing questions Create documentation for external customers and payers in regard to premium balances as well as billing statements Contact customers by phone or in writing to verify data, apprise of billing issues as well as assist with resolution for outstanding balances Maintain timel

Interact with customers to gather support data to ensure invoice accuracy and also work through specific billing discrepancies Educate customers regarding the availability of receiving invoices and remitting payments through online applications Resolved concerns related to patient balances on their accounts Handles inbound calls Routes accounts for review and resolution P

Interact with customers to gather support data to ensure invoice accuracy and also work through specific billing discrepancies Provide input to policies, systems, methods and procedures for the effective management and control of the premium billing function Manage the preparation of claims and complete reconciliation of billing with accounts receivables You'll be rewarde

Performs all duties within the scope of a Medical Assistant's practice. Operates diagnostic equipment (cannot interpret tests), remove staples from superficial wounds, changes wound dressing and obtains cultures, administers non intravenous medication, performs simple specimen collection via noninvasive techniques and collects blood specimens via venipuncture or via capil

Performs all duties within the scope of a Medical Assistant's practice. Operates diagnostic equipment (cannot interpret tests), remove staples from superficial wounds, changes wound dressing and obtains cultures, administers non intravenous medication, performs simple specimen collection via noninvasive techniques and collects blood specimens via venipuncture or via capil