This position is responsible for performing compliance monitoring of sub contracted organizations, working collaboratively with departments across CareOregon. Primary responsibilities include delegation oversight, process improvement, and reporting. Essential Responsibilities Delegation Oversight Work at the guidance of and with input from the Regulatory Manager to interp

The Health Care Coordinator (HCC) acts an entry point to CareOregon's Regional Care Teams, as well as provides care coordination. This position provides intake functions, physical and behavioral health plan navigation, and care coordination including assessing member needs, developing individualized care plans, coordinating with providers and with members. A focus of this

The Senior Pharmacy Clinical Coordinator is responsible for coordinating with staff and providing pharmacy oversight of a line of business (LOB) (i.e., Coordinated Care Organization (CCO)) or the pharmacy network (i.e., clinical and community pharmacists). Responsibilities include developing and delivering clinical and educational interventions designed to improve pharmac

This position is responsible for working with CareOregon members, their providers, and pharmacies to support the pharmacy benefit and prescription needs under the major medical benefit. This is an advanced level support position, requiring Pharmacy Technician Certification. Core responsibilities include customer service, claims processing, prior authorizations, formulary

A Milwaukee Public Schools Speech Language Pathologist refers to the professional who applies the principles, methods and procedures for the assessment, prognosis, counseling, instruction, habilitation or rehabilitation related to the development and disorders of speech, voice or language production and comprehension. Master's Degree in Communicative Disorders or similar

The school Nurse Associate (LPN) provides nursing care for students with chronic or special health care needs in the elementary, middle and high school setting under the direction and supervision of a Milwaukee Public Schools Nursing Supervisor. Licensure through National Council for State Boards of Nursing LPN Credentials Only Must be CPR certified One year of hands on e

Job Summary The Plant Health Care Team are specialists dedicated to inspecting plant material, identifying problems, and ethically treating or preventing the many problems that trees and shrubs may face. They are our team of "detectives"; looking at each plant disease/infestation as a puzzle they can't wait to solve. This role provides the opportunity to work outside and v

Love your job while making a difference !

Analyze and summarize medical records Create medical chronologies and narrative summaries of medical records Create billing record summaries in Excel Determine, prepare and organize materials needed for expert witness review Conduct investigative research on expert witnesses Why Should You Apply? Excellent Benefits including a 401k match Generous PTO plan Excellent growth

Community Newcastle Place Address 12600 N Port Mequon, Wisconsin 53092 Pay Range $121,000.00 $172,250.00+ Annual Live your purpose. Grow your career. Thrive through teamwork. Create meaningful, personalized experiences. At Lifespace, team members are at the center of delivering a purpose driven experience for our residents! We provide an environment where each team member

RN CASE MANAGER HOSPICE $7,500 SIGN ON BONUS! Job Locations US WI JACKSON ID 2024 143626 Line of Business Allay Home and Hospice Position Type Full Time Our Company Allay Home and Hospice Overview $7,500 SIGN ON BONUS! Our Hospice Registered Nurse (RN) Case Managers are the heart of our organization! In this role, you will support your patients by providing direct care an

Applies medical necessity screening criteria, level of care guidelines, and professional nursing knowledge to ensure that admissions and length of stay are appropriate. Completes initial admission and thereafter continuing stay reviews for all hospitalized patients. Facilitates utilization review concurrent with decisions on hospitalization and may perform duties in the E

Conducts periodic on site safety inspections, analyzing work practices to determine safe and efficient methods of performing work. Determines corrective or preventative means and methods where indicated and follows up to ensure they have been implemented. Documents information in relevant reports and analyzes data to make control and improvement recommendation(s). Partner

Conduct in home assessments on health plan members, including past medical history, review of symptoms, physical examination, medication review and depression screening 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 pat

Uses the nursing process to provide ongoing care (assess, plan, intervention, and evaluation). Recognizes and responds to changes in a patient's status and need for care. Determines priorities of patient care based on essential patient needs. Provides triage and consultation to patient, family, and/or significant others according to protocol and organization guidelines. C