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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 caregiver support, and wil
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Works within department strategic vision, objectives, and policies and procedures. Participates in building objectives each year Regularly meet with cross functional team to assist in creating, evaluating and adjusting strategy for assigned provider groups to meet overall performance goals. Provides explanations and interpretations within area of expertise Establish and maintain effective business
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Approach every project with a human centered, design thinking mindset Use the Action Mapping framework to translate concepts into action and create focused deliverables that drive measurable behavior change and results Create actionable learning campaigns and help drive teammate engagement Work with clinical, operational and business leaders to create content specific to teammate personas and ali
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Build and maintain operational relationships with clients to ensure customer satisfaction Establish and maintain contact (verbal and written) with customers for referral submission through case closure per client/claim handling instructions and service standards Understand client specific requirements and clearly and quickly communicate issues based on the needs of the client Understand claim flow
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Responsible for establishing and maintaining positive relationships and actively marketing to referral sources within the hospital, physician offices, or healthcare facilities Information resource for home health service/SNF services Resources for early intervention Assist complex patient conferencing as needed Daily rounds on hospital floors and morning meetings with all case managers to collabo
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Provide information to clients, family members, and other stakeholders about treatment options, natural supports / community resources, to aid in member recovery from substance use Provide encouragement and motivation to members considering treatment or recently discharged from treatment Give presentations to clients, family members and professionals as needed Assist UM / CM staff to identify stre
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Field inbound calls on a queue from members and providers for the purpose of assessment and triage Focus on initial inpatient admission for psychiatric and chemical dependency patients Make patient assessments and determine appropriate levels of care Determine if additional clinical treatment sessions are needed Manage inpatient mental health cases throughout the entire treatment plan Administer b
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Provide information to clients, family members, and other stakeholders about treatment options, natural supports/community resources, to aid in member recovery from substance use. Provide encouragement and motivation to members considering treatment or recently discharged from treatment. Give presentations to clients, family members and professionals as needed. Assist UM/CM staff to identify stren
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Ability to read, interpret and comprehend insurance payment Remittance Advice/ Explanation of Benefits Review, appeal or request claim reprocessing to represent correct processing of insurance claims Contact insurance companies regarding claim processing and determining reason for payment delinquency or claim denial Contact various departments to help with corrections and submit appeals for outsta
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Drive MA growth throughout the entire year to meet and/or exceed established member retention and net growth goals during OEP, SEP, and AEP. Promote MA growth throughout the various broker sales channels. Serve as primary point of contact for the company within the broker community, leading contracted and independent broker agency activity within Colorado. Identify and execute opportunities for br
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The Lead Medical Assistant is responsible for the day to day functioning of all back desk areas. These areas include phlebotomy, medical assisting, medical procedures, phone triage, Protocols for EMR, managed care referrals, and X ray services. Primary Responsibilities Supervises the day to day functioning of all clinical areas of the practice, working closely with and taking direction from the p
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Audit clinical documentation and provide training and education to providers and staff on Evaluation and Management documentation and code assignment requirements. Coordinate and attend annual external compliance audit education for all providers. Support Coding team to help with coding questions. Support Customer Service and AR teams when documentation and coding review is needed to resolve com
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Performs general nursing care to patients. Administers prescribed medications and treatments in accordance with nursing standards. Assists with the preparation of equipment and aids during treatment, examination, and testing of patients. Observes, records, and reports patient's condition and reaction to drugs and treatments to physician. Administers prescribed medications as directed. Oversees
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Coordinate work for, and work with, Claim Representatives, Appeal Analysts, triaging medical records, setting up claim appeals in Optum Systems, and other duties to be determined. Set up Appeals (includes receive, analyze, evaluate, and track appeal documents; follow inquiries and complaints through final resolution) by established processes and procedures, and within established time standards. P
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Combine two of the fastest growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Joi
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