• Description contains certified nurse: +3 results
ProfessionalPosition Purpose: Ensure Coding Analytics team consistently meets production standards and passes quality audits Oversee relationships with health plans, claims, and other departments resulting in a significant impact on Centene's ability to meet key performance indicators Identify and implement best practices and operational efficiencies Serve as a health plan account liaison by le...
Balance Screening Assessment presented by Jennifer Ellis, PT, DPT, Ph.D., MS, GCS, COS-C, VP, Division Research & Business Development at Kindred at Home Statistics confirm that, in the U.S. an older adult falls every 2nd. National Council on Aging confirms that early identification of fall risk, paired with pro-active prevention, can reduce both fall and injury rates among adults over age 65. ...
HourlyPosition Purpose:Complete medical reviews on high dollar claims to confirm alignment with services provided. Perform prospective review for medical necessity appeals against medical review criteria to make benefit of determinations. Utilize standard methodology and medical criteria sets to analyze and interpret member and/or provider claims, eligibility and quality data. Identify potentia...
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