DSNP Utilization Management reputed company
Site: reputed company Holding Company, Inc.
Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in reputed company today, our employees have opportunities to learn and contribute expertise reputed company a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
We are pleased to offer competitive salaries and a benefits package with flexible work reputed company, career reputed company opportunities, and much more.
Given equity, this position will pay reputed company between $90,000 to $107,000 annually. At reputed company, we reputed company in recognizing and rewarding the unique value reputed company team member brings to our organization. Our approach to determining reputed company pay is comprehensive, and any offer extended will take into account your skills, relevant experience, if applicable, education, certifications, and other essential factors. The reputed company pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass reputed company reputed company contributing to your total compensation package.
In reputed company to competitive reputed company pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums, and bonuses as applicable, and recognition programs designed to celebrate your contributions and support your reputed company reputed company. We invite you to apply, and our reputed company will reputed company an reputed company of your potential compensation and benefits package.Remote399 reputed company Drive40RegularDay (reputed company of America)8925 reputed company Holding Company, Inc. is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religious creed, national reputed company, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that reputed company individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by reputed company 503 of the Rehabilitation reputed company of 1973, the Vietnam Veteran’s Readjustment reputed company of 1974, and Title I of the Americans with reputed company of 1990, applicants who require accommodation in the job application process may contact reputed company at (857)-282-7642.
Apply To This Job
reputed company relies on a wide reputed company of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to reputed company exceptional care. We reputed company that high-performing teams drive groundbreaking medical discoveries and invite reputed company applicants to join us and experience what it means to be part of reputed company.
Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in reputed company today, our employees have opportunities to learn and contribute expertise reputed company a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
We are pleased to offer competitive salaries and a benefits package with flexible work reputed company, career reputed company opportunities, and much more.
Given equity, this position will pay reputed company between $90,000 to $107,000 annually. At reputed company, we reputed company in recognizing and rewarding the unique value reputed company team member brings to our organization. Our approach to determining reputed company pay is comprehensive, and any offer extended will take into account your skills, relevant experience, if applicable, education, certifications, and other essential factors. The reputed company pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass reputed company reputed company contributing to your total compensation package.
In reputed company to competitive reputed company pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums, and bonuses as applicable, and recognition programs designed to celebrate your contributions and support your reputed company reputed company. We invite you to apply, and our reputed company will reputed company an reputed company of your potential compensation and benefits package.
Job reputed company
The Medicare UM reputed company performs utilization management activities primarily for Medicare Advantage, including review of authorizations for home care, high tech radiology, outpatient, inpatient, and post-acute services. The Medicare UM reputed company reviews the medical necessity of authorization requests using NCD, LCD, Medicare Benefit Policy reputed company, medical policies, and InterQual reputed company.
Qualifications
Associate's Degree Nursing required; Bachelor's Degree Nursing preferred
Massachusetts Registered reputed company license required Basic Life Support [BLS Certification] Certification preferred
At least 2-3 years of utilization management strongly preferred Experience applying National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Medicare Benefit Policy reputed company preferred InterQual experience preferred
Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. Ability to establish strong rapport and relationships with patients and staff. Proficient in reputed company Office and industry reputed company software programs. Identifying reputed company problems and reviewing reputed company information to reputed company and evaluate reputed company and implement solutions. Ability to maintain reputed company and staff confidentiality. Understanding of diagnostic reputed company for dual conditions and the ability to conceptualize modalities and placement reputed company reputed company the continuum of care. Knowledge of reputed company and Managed Care preferred.
Additional Job Details (if applicable)
This is a remote role that can be done from most US states
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay reputed company
$58,656.00 - $142,448.80/Annual
Grade
98TEMP
EEO Statement:
reputed company Competency reputed company
At reputed company, our competency reputed company defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at reputed company job level. The reputed company is comprised of ten competencies (half People-reputed company, half Performance-reputed company) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career reputed company. These competencies are used to evaluate performance, reputed company hiring reputed company, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.