Supervises clinical operations of a given patient care area Assists Site Administrator in ensuring compliance with licensing, certification, and competencies Evaluates nursing competencies and decisions according to current nursing practices Functions as a resource and serves as a liaison between administration, clinicians, staff, and other departments Participates in all

Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants Establishes and maintains effective relationships with patients, care givers, and/or their legal representatives, IDT members, PCPs, other collaborating physicians/providers, and facility staff when applicable Performs an initi

Acts as resource to members calling into a customer service setting addressing medical/health questions Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow up with the member Provide process and status on previously submitted prior authorizations or pre determination requests Effectively refers and enrolls memb

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Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Conduct comprehensive assessments Manage members through an acute medical situation or an exacerbation of a chronic condition, including testing, diagnostics, interventions Manage members during a short term sub acute rehabilitation episode Ensure accurate and complete documentation, including ICD 10 conditions Communicate and collaborate with the interdisciplinary care t

Careers with MedExpress. At MedExpress, we believe in delivering quality, convenient, affordable health care and exceeding our patients' expectations. Our neighborhood medical centers are open every day from 8 8 with a full medical team and no appointments necessary to help patients get in, get healthy, and get back to what's really important . We provide a broad scope of

Greets patients as they arrive and manages wait time Complete check in and check out tasks to include insurance verification, and copy required documents Collects co payments, co insurance, and deductibles and issues receipts Processes walk in patients and visitors Answers phones and schedules appointments Answer telephone calls, re direct calls as appropriate, assist cal

Primary Care Delivery Deliver cost effective, quality care to assigned members Manage both medical and behavioral, chronic and acute conditions effectively, and in collaboration with a physician or specialty provider Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Me

Conduct comprehensive assessments Manage members through an acute medical situation or an exacerbation of a chronic condition, including testing, diagnostics, interventions Manage members during a short term sub acute rehabilitation episode Ensure accurate and complete documentation, including ICD 10 conditions Communicate and collaborate with the interdisciplinary care t

Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants Establishes and maintains effective relationships with patients, care givers, and/or their legal representatives, IDT members, PCPs, other collaborating physicians/providers, and facility staff when applicable Performs an initi

Establish and maintain positive clinical rapport with patients and their families, working closely with them in the provision of infusion therapy, education related to self care and self administration, and clinical monitoring of patient response to therapy Assess patient appropriateness for home infusion therapy, including safety of the home environment, availability of

Accurately schedules and coordinates patient appointments for assigned clinics The ability to work in a high call volume environment while meeting productivity and quality standards Analyzing provider schedules to ensure maximum capacity is met Obtains eligibility and benefit information in a timely manner assigning FSC (Financial Class) entering benefits and all other re

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

Perform initial and concurrent review of inpatient cases applying evidenced based criteria (i.e. MCG / Interqual criteria) Discuss cases with facility healthcare professionals to obtain plans of care Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management Participation in discussions with the Clinical Services team to imp