16 to 30 of 3,437
The Practice Performance Manager is responsible for program implementation and provider performance management which is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and coding accuracy The person in this role is expected to work directly with care providers to build relationships, ensure effective education and reporting, proactively identify performance improv
Posted 1 day ago
Manage, mentor and evaluate staff with a focus on provider and practitioner quality, provider pricing, compliance with network requirements, department efficiency and department goals Communicate effectively and directly with internal and external customers at all levels within the organization Develop strong provider and practitioner relationships; assist in management of strategic vendor partner
Posted 1 day ago
Make outbound calls to assess members' current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self management Interact with Medical Directors on challenging cases Coordinate care for members Make referrals to outside sources Coordinate services as needed (home health, DME, etc.) Educate members on disease processes Encourage members to make heal
Posted 1 day ago
Analyze pricing and risk assumptions Develop new rates, prepare cost estimates and conduct and evaluate studies on pricing, utilization and health care costs for our broad range of clients Research, study, and compare existing business trends to macro internal and external trends Participate in client relationships Design and run complex data programs Perform quantitative analysis of Actuaria
Posted 1 day ago
Demonstrate respect for patients and ProHealth staff by presenting a friendly, courteous manner at all times and maintaining patient confidentiality Provide attention to patients in a manner that builds confidence, trust and loyalty Conduct outreach to patients requiring appointments from existing work list in EHR for internal referred patients or from faxed referrals via non PHP providers Triage
Posted 1 day ago
Assist in end to end provider claims and help enhance call quality Assist in efforts to enhance ease of use of physician portal and future services enhancements Contribute to design and implementation of programs that build / nurture positive relationships between the health plan, providers and practice managers Support development and management of provider networks Help implement training and de
Posted 1 day ago
Establishework procedures and standards to improve efficiency and effectiveness in the office AssistSenior Practice Manager and physician(s) to develop and implement long range plans Manageoffice operations to maximize patient access, patient satisfaction, and collection of payments Coordinatesstaff and provider schedules to ensure proper coverage for quality patient care Managehuman resources hir
Posted 1 day ago
Focus on initial admission for psychiatric and chemical dependency patients Make patient assessments and determining appropriate levels of care Obtain information from providers on outpatient requests for treatment Determine if additional clinical treatment sessions are needed Administer benefits and review treatment plans Coordinate benefits and transitions between various areas of care Identify
Posted 1 day ago
Determine the appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination Identify solutions to non standard requests and problems Translate concepts into practice Act as a resource for others; provide explanations and information on difficult issues This position will require active and unrestricted Nursing licensure in multiple US Sta
Posted 1 day ago
Create a positive experience and relationship with the member Help member set goals and develop a care plan to achieve those goals Proactively engage the member to manage their own health and healthcare Support the member to improve their wellbeing by staying out of the hospital, and attend regular visits to their primary physician As needed, help the member engage with mental health and subst
Posted 1 day ago
Determine the appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination Identify solutions to non standard requests and problems Translate concepts into practice Act as a resource for others; provide explanations and information on difficult issues This position will require active and unrestricted Nursing licensure in multiple US Sta
Posted 1 day ago
Regular, consistent, on site, and timely attendance Schedules patient appointments for designated departments Schedules appointments utilizing scheduling software tools Provides testing instructions to assure smooth services Secures authorization and referral if applicable Customer Focus. Assesses customers' needs and considers customer in all decision making processes to ensure a positive custome
Posted 1 day ago
Assist in opening and closing the clinic, locking and unlocking the doors, and maintaining a clean waiting area Welcome all On Site Clinic patients and visitors by greeting them with a friendly demeanor, answering inquiries and directing them through the registration process. Answer multi phone lines, filing, faxing, scanning documentation and completing daily patient callbacks Collect all insuran
Posted 1 day ago
Assist in opening and closing the clinic, locking and unlocking the doors, and maintaining a clean waiting area Welcome all On Site Clinic patients and visitors by greeting them with a friendly demeanor, answering inquiries and directing them through the registration process. Answer multi phone lines, filing, faxing, scanning documentation and completing daily patient callbacks Collect all insuran
Posted 1 day ago
Create a positive experience and relationship with the member Help member set goals and develop a care plan to achieve those goals Proactively engage the member to manage their own health and healthcare Support the member to improve their wellbeing by staying out of the hospital, and attend regular visits to their primary physician As needed, help the member engage with mental health and substance
Posted 1 day ago
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