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Community Care Manager

Pozent - Des Moines, IA
Registered Nurse OR LS/MSW with an unrestricted license to practice in the state of Iowa Required CCM Highly desired Similar level or related experience including demonstrated expertise conducting health assessments and delivering care in a clinical ... - Jun 25

Care Connector

Pozent - Philadelphia, PA
... Under the direction of Clinical staff, the Care Connector will provide members with educational materials and carry out strategies to increase health care adherence and reduce barriers to care. Working knowledge of Plan Benefits and Services Highly ... - Jun 25

Care Manager

Pozent - Washington, DC
... Identifies and implements the appropriate level of intervention based upon the member's needs and clinical progress. Schedules follow up calls as necessary, makes appropriate referrals. Implements actions to address member issues. Documents progress ... - Jun 25

Clinical Care Reviewer - UM

Poz - Harrisburg, PA
3 or more years experience in a related clinical setting.Registered NurseExcellent oral and written communication skills.Ability to identify problems and recommend solutions.Self-directed/Ability to work independently.Excellent decision making ... - Jun 25

DME Specialist

Poz - Harrisburg, PA
... Routes case to appropriate AMHP's Clinical Coordinators, Case Managers, DME specialists for continuation of medical necessity review process.12. Communicates case specific information as indicated to AmeriHealth Mercy Health Plan providers. ... - Jun 25

HEDIS Specialist

Pozent - Harrisburg, PA
... Experience with abstracting clinical information from medical records - Required Experience with the use of Windows-based PC applications with emphasis on word processing, database, and spreadsheet software. - Required Knowledge of NCQA HEDIS ... - Jun 25

Behavioral Health Medical Dir

Pozent - Baton Rouge, LA
... with a current unencumbered license through the State Board of Medical ExaminersBoard Certified Psychiatrist with an unrestricted license to practice in Louisiana and any other applicable states, with five years clinical psychiatric experience. ... - Jun 25

Prior Auth Coord - REG

Pozent - Atlanta, GA
Experience in a related clinical setting- 3 years Required Managed care or utilization review experience - Highly Desired A medical doctor/registered nurse or physician’s assistant- Required Must reside in Atlanta, GA - Jun 25

Care Manager

Pozent - Washington, DC
... Identifies and implements the appropriate level of intervention based upon the member's needs and clinical progress. Schedules follow up calls as necessary, makes appropriate referrals. Implements actions to address member issues. Documents progress ... - Jun 25

UM Tech

Pozent - Harrisburg, PA
... Refers as appropriate to clinical team members for review as defined by workflow. 4. Performs in a call center environment appropriately processing or triaging calls from providers. 5. Creates, updates maintains and/or closes authorizations for ... - Jun 25
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