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

Develop market business plans to motivate providers to engage in improving Stars measures to be 4 STARS or higher Provide analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups Be the primary go to person for all STARS related activities within their assigned market(s) working within a matrix relationship which in

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 LVN (procedures, injections, diagnostic testing, phlebotomy) Coordinates healthcare screening results as directed by providers, company standards, and policies Broad knowledge of information required to complete health screenings required Travels with the mobile team to clinics and centralized locations to conduct screening clinic

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start C aring. Connecting. Growing together. The Clinical Quality Consultant II (CQC) will drive consistency, efficient processes and share best practices, in a collaborative effort wit

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 ident

Provides direction and leadership to designated Agency personnel in an effort to ensure quality and continuity of services through competent personnel management skills Ensures that all supervised health care staff maintains compliance of federal and state rules and regulations and to agency clinical policies, procedures, and appropriate standards of care Ensures that a c

Oversee the management of building inpatient admissions and post acute cases, ensuring that the admissions process is efficient and that turnaround times are met. Handle incoming clinical records by reviewing, organizing, and attaching them to the associated inpatient case in a timely manner. Respond to incoming calls, providing exceptional customer service, and directing

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

Opportunities at WellMed , part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non patient facing roles, you can make a difference with us as you discover the meani

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Completes assigned daily cases by processing prior authorization and medical necessity requests for specialty CMS part B medications and meet production, performance metrics as determined by the department in order to comply with CMS Part B turnaround times (TAT) Review specialty medication prior authorization requests (i.e. biopharmaceuticals) according to established tr

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 Coord

The Physical Therapist Assistant (PTA) contracted or employed through the Organization is responsible for implementation of standards of care for physical therapy services and for adherence to all conditions outlined in the Personnel Services Agreement. The PTA, under the supervision of a physical therapist (PT), administers medically prescribed physical therapy for patie

Performs nursing assessments and develops, implements and evaluates plans of care in conjunction with the physician, patient and caregivers per agency policy and procedure Evaluates the effectiveness of the plan of care, the patient's response to care and outcomes of care and revises the plan of care as needed Re evaluates patient nursing needs to include on going assessm