Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from providers/members as well as research and resolve formulary and benefit issues using the appropriate reference material Process authorizations through various computer systems and use of job aid/policies/procedures ensuring the accuracy of all data and updating as necessary Have

Maintains an active nursing appointment schedule for assisting the Provider in the monitoring of members' health care needs Assists the Care Manager and Provider in the follow up management of post hospitalized or post emergency room visits Comprehensively screens patients for care opportunities and collaborates with treating physician and/or Registered Nurse to develop c

Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer. Represents the Company in a professional manner, following all Company policies and procedures. Uses, protects, and discloses patients' protected health information (PHI

Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer. Represents the Company in a professional manner, following all Company policies and procedures. Uses, protects, and discloses patients' protected health information (PHI

Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and appropriate measurement tools, such as nH Predict, nH Outcome, InterQual and CMS criteria, upon admission to SNF and periodically through the patient stays Review targets for Length of Stay (LOS), target outcomes, and discharge plans with providers and families Complete all SNF concur

Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer Under direction and supervision of physician, administers medications, administers immunizations, EKGs, ear washes, and other patient services. Assists in simple office a

Provide telephonic patient outreach and patient experience calls Coordinates patient care as directed by physicians, company standards and policies Supports and follows Standard Delegation of Orders (SDO) Schedules all new patient evaluations for Palliative Care. Schedules all follow up appointments for Palliative Care Physicians, RN's and LVN's Responsible for mapping pa

Assist physicians and nursing personnel with injections, EKGs, phlebotomy and other patient care procedures Maintain established quality control standards Record and process patient care documentation quickly and accurately Coordinate patient care as directed by physicians, company standards and policies Organize, stock and clean exam and treatment rooms and sterilize ins

Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer Represents the Company in a professional manner, following all Company policies and procedures Uses, protects, and discloses patients' protected health information (PHI)

Greet patients as they arrive Assist patient with intake processes including copying required documents Collect co payments, co insurance and deductibles and issues receipts Process walk in patients and visitors Answer phones and schedule appointments Manage medical records (maintains, files / scans, prepares for schedule) Ensure all correspondence is scanned and / or fil

Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer Represents the Company in a professional manner, following all Company policies and procedures Uses, protects, and discloses patients' protected health information (PHI)

Optum Florida is seeking a nurse practitioner or physician assistant to join our Optum Park Place clinic. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they n

Assist physicians and nursing personnel with injections, EKGs, phlebotomy and other patient care procedures Maintain established quality control standards Record and process patient care documentation quickly and accurately Coordinate patient care as directed by physicians, company standards and policies Organize, stock and clean exam and treatment rooms and sterilize ins

Total coordination and processing of all patient referrals for specialty services Enters all referral, hospital, outpatient, DME and other patient specialty health service authorizations into the computer system according to Company policy and procedure Receives consultant reports, maintains documentation, and routes to the appropriate physician promptly. Coordinates pre

Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer Under direction and supervision of physician, administers medications, administers immunizations, EKGs, ear washes, and other patient services. Assists in simple office a