Managed Care Marketing Manager develops and implements marketing plans for a managed care organization. Promotes the organization's services to potential members and business partners. Being a Managed Care Marketing Manager identifies and targets new opportunities and sources of additional business and revenue. Requires a bachelor's degree. Additionally, Managed Care Marketing Manager typically reports to a head of a unit/department. The Managed Care Marketing Manager typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Managed Care Marketing Manager typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Insurance Managed Care RN - UR/CM
Precedence, Inc., Rock Island, IL
Remote or Hybrid with Experience - Based Off Of Location
Full-Time Benefits
M-F, 8-5
The Managed Care RN Utilization/Case Manager, under the direction of the Director of Managed Care serves a key role in coordinating the patient’s/enrollees interdisciplinary providers/services to assess and effectively use resources and to track and minimize the inappropriate use of such resources while providing the right care at the right level at the right time. This role is responsible for utilization management and case management for patients/enrollees. This includes payment authorizations, clinical coordination, integration and facilitation of all care and services for the patient by all members of the health care team.
This role performs admission assessment, continued stay reviews all according to established criteria of third party carriers, and as found necessary on cases with third party payor review. Monitoring of plan of care to address physical and psychosocial needs, and provide problem solving assistance. Coordinates services, discharge planning, referrals to appropriate community agencies and assists with Advance Directives when appropriate. Responsible for reviewing and updating critical paths with healthcare team when applicable. Also, assessing, monitoring, analyzing and documenting resources utilized in the provision of patient care.
Why UnityPoint Health?
Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. https://dayinthelife.unitypoint.org
#RYCJessi
Education:
Registered Nurse
Experience:
5 years of nursing experience
License(s)/Certification(s):
Registered Nurse – Illinois Licensed
Knowledge/Skills/Abilities:
#QC123
Clear All
0 Managed Care Marketing Manager jobs found in Rock Island, IL area