Manage administrative intake of members Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review

Seeking an RN Care Manager II to p rovide Care Management duties to include telephonic outreach to members, assess members for complex medical needs, develop and update care plans, assess members current health , resource utilization , assess progress to goals , assist member with coordinating services and appointments , provide member education, assist with access to com

Data Capture Specialist is responsible for the accurate capture of the alphabetic, numeric, or symbolic data from electronic images and/or source documents according to the custom developed software application including repair of incorrect data resulting from OCR process (optical character recognition results). Pay Rate $14.85hr (Weekly Pay) Work Schedule Monday (9 00 am

PME is looking for a Healthcare Case Manager I (RN, LCSW, LMSW) experienced in Case Management working with complex medical and mental illness cases. The position will require field visits 3 days a week and the rest will be from home. Schedule M F 8 30am 5 00pm CST. MUST live in within 30 minutes of ARLINGTON HEIGHTS, BARTLETT, HANOVER PARK, BARRINGTON, ELGIN, MOUNT PROSP

Professional Management Enterprises, inc. is looking for an entry level Technical Writer. Their role is to employ their technical knowledge to research, document, and present detailed information in easy to interpret guides, help manuals, white papers, templates, web pages, videos, journal articles, etc. The Technical Writer will transform complex information into concise

The trainer is responsible for facilitation of a range of training content, primarily for Indiana early childhood education professionals and program leaders, SPARK IN staff/partners, and for broader external audiences. This position is remote in Indiana, with travel to provide training coverage . Essential Duties & Responsibilities Supports the implementation of technica

Educate individuals on the importance of nutrition, safety, and overall good health. Provide knowledge and advice through our triage line. Engage callers to assess and de escalate uneasy situations in the least restrictive manner to ensure caller safety over the phone. Report to assigned supervisor and actively seek consultation whenever necessary or requested by supervis

ESSENTIAL DUTIES MAY INCLUDE Following policy in critical incidents preventing injury, escape, or property damage. Maintains confidentiality. Incumbent supervises the daily work of students and evaluates the achievement of individual student knowledge. Operates all job related equipment. Collaborates with other departments in order to enhance the learning environment of s

Seeking a RN to function as a Medical Affairs Coordinator . This position if fully remote. The schedule is M F, 9am 5pm. DUTIES Ensures that the Local Coverage Determination (LCD) process adheres to contract instructions. Creates, implements, and maintains educational tools to help providers reduce the submission of claims for non covered services and reduce the claims pay

DUTIES Analyzes current operational functions and offers and implements improvements. Maintains databases and extracts data for analysis from multiple systems and departments using various data manipulation and extraction techniques. Runs and reviews reports, analyzing results in support of operational functions. Summarizes findings and communicates results to management.

Will be responsible for performing case management activities according to the contractual requirements and in alignment with NCQA requirements. Manage a caseload of approximately 130 LTC (Long Term Care) cases. Complete face to face visits with members in the LTC facilities at a minimum of an annual visit per member. Complete an annual assessment, assessment summary (DAR