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.
...NDT Certified Inspectors Needed Southern Tool Inspection is one of the fastest-growing inspection companies in the Oil and Gas Industry. STI provides inspection services of all Downhole Tubular Goods. Our immediate needs: We need NDT certified inspectors with...
...We are seeking an experienced Fund Accounting Manager to oversee accounting operations and client service for private equity and hedge fund clients. This is an excellent opportunity for a fund accounting professional with management experience to take on a leadership...
...As a Dunkin' Donuts franchisee, we are seeking full and part time cake decorators to join our team of cake artists. Hours are flexible and can be completely independent! Key responsibilities include: Receiving and processing online, phone, and in person cake orders...
...Hickory Creek Crawfordsville now providing FREE Certified Nursing Assistant (CNA) Training Turn your Caring Spirit into a CAREER! The ASC Nurse Aide Training Program is an opportunity that requires no previous experience, just a commitment to providing compassionate...
...IT Helpdesk TechnicianSalt Lake CityWelcome to the Traegerhood: Our business is BBQ, and business tastes good. Traeger invented the wood... ...(IRU) for enrollment, policy deployment, compliance, and remote managementSupport Microsoft 365 / Azure AD (Entra ID) administration...