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RN-Manager Healthcare Services II/Managed Care/Insurance

RN-Manager Healthcare Services II/Managed Care/Insurance

Job Description


JOB REQUIREMENTS

Knowledge/Skills/Abilities

• Demonstrated ability to communicate, problem solve, and work effectively with people.
• Excellent organizational skill with the ability to manage multiple priorities.
• Work independently and handle multiple projects simultaneously.
• Strong analytical skills.
• Knowledge of applicable state, and federal regulations.
• Knowledge of ICD-9, CPT coding and HCPC.  * for Behavioral Health focused CM knowledge of DSM IV TR and DSM 5 diagnostic coding
• Knowledge of SSI, Coordination of benefits, and Third Party Liability programs and integration.
• Familiarity with NCQA standards, state/federal regulations and measurement techniques.
• In depth knowledge of CCA and/or other Case Management tools.
• Ability to take initiative and see tasks to completion.
• Computer skills and experience with Microsoft Office Products.
• Excellent verbal and written communication skills.
• Ability to abide by Molina’s policies.
• Able to maintain regular attendance based upon agreed schedule.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers.

Job Requirements


JOB REQUIREMENTS

Knowledge/Skills/Abilities

• Demonstrated ability to communicate, problem solve, and work effectively with people.
• Excellent organizational skill with the ability to manage multiple priorities.
• Work independently and handle multiple projects simultaneously.
• Strong analytical skills.
• Knowledge of applicable state, and federal regulations.
• Knowledge of ICD-9, CPT coding and HCPC.  * for Behavioral Health focused CM knowledge of DSM IV TR and DSM 5 diagnostic coding
• Knowledge of SSI, Coordination of benefits, and Third Party Liability programs and integration.
• Familiarity with NCQA standards, state/federal regulations and measurement techniques.
• In depth knowledge of CCA and/or other Case Management tools.
• Ability to take initiative and see tasks to completion.
• Computer skills and experience with Microsoft Office Products.
• Excellent verbal and written communication skills.
• Ability to abide by Molina’s policies.
• Able to maintain regular attendance based upon agreed schedule.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers.





Abe Ghebrehiwet

Senior Account Executive

Nurse Resolutions

888.411.2228. X 204 Toll Free

407.982.7508. Fax          

www.NurseResolutions.com

[Click Here to Email Your Resumé]



Job Snapshot

Employment Type Full-Time
Job Type Health Care
Education Not Specified
Experience Not Specified
Manages Others Not Specified
Relocation No
Industry Healthcare - Health Services
Required Travel Not Specified
Job ID abe
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RN-Manager Healthcare Services II/Managed Care/Insurance


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