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All stakeholders should know the hospital’s mission, vision, and priorities.\r\n Works with the Board, senior management team, physicians and staff to develop, implement, and update strategies and opportunities for growth and improvement to support the hospital’s mission and respond to external and internal issues.\r\n Is responsible for the operational, strategic, financial and clinical performance of the hospital.\r\n Provides for a system of control which clearly identifies deviations from plans and budgets; assure periodic comparison of performance and/or results against established standards for objectives; assure corrective actions for deviation from plans so that annual results are in line with strategic goals.\r\n Maintains the hospital’s compliance with all regulatory and legal requirements.\r\n General Duties\r\n Keeps abreast of new legislative information that impacts the hospital and clinics.\r\n Establishes personal and professional credibility and an environment of trust, candor and genuine two way communications.\r\n Serves as a positive role model and mentor.\r\n Educates and promotes customer service throughout entire facility.\r\n Provides hospital operations coaching or mentoring.\r\n Attracts and retains physicians; maintain high levels of physician satisfaction.\r\n Works closely with the medical staff to ensure quality care, resolve conflicts and remove barriers to physicians admitting and referring to the hospital.\r\n Implements Board education and development programs through internal and external resources.\r\n Takes a proactive approach to managed care, healthcare reform and related issues. \r\n Develops new business opportunities. \r\n Active participation within the community, participates in and represents the hospital in professional, civic, and service organizations.\r\n Participates in meetings that affect the hospital.\r\n Upholds and supports Morehouse General Hospital and individual hospital’s mission, vision, values, goals and objectives.\r\n Supervisory Responsibilities\r\n Manages subordinate leader(s) who supervise employee(s) and/or supervise individual contributors as appropriate.\r\n Defines and communicates performance expectations. \r\n Plans, assigns and directs work: follows up to assesses achievement of results. \r\n Evaluates performance; coaches employees on an ongoing basis and takes developmental action as needed. \r\n Rewards and recognizes notable performance.\r\n Addresses complaints, resolves problems and promptly addresses unacceptable behavior. \r\n Attracts, develops and retains talent.\r\n Carries out supervisory responsibilities in accordance with CHC's/hospital's policies and applicable laws. \r\n Requirements\r\n Master's Degree in a healthcare related field or a BS in a healthcare related field with a business related masters, or the equivalent in education and experience.\r\n Minimum 7 years of executive leadership experience in a hospital or healthcare setting.\r\n CEO experience required.\r\n Leadership and experience in a small town environment with a track record of effective operational, financial, business development, and strategic skills. \r\n Strong interpersonal and communication skills, with the proven ability to proactively develop positive relationships with physicians, employees, Board members and community leaders. \r\n Exceptional critical thinking and decision-making abilities with a track record of leading staff to providing strong focus on patient safety and quality of care.\r\n Must have a track record of leading staff to provide safe quality patient care.\r\n Rural Health Care Clinic experience preferred.\r\n \r\nSkills and Knowledge\r\n Ability to enhance a quality of care environment, positive clinical outcomes and a high level of patient, physician and employee satisfaction.\r\n Ability to mentor and cultivate a talented management team.\r\n Ability to lead a high performing team and achieve results through others. \r\n Ability to work with all levels of management and respecting all differences.\r\n Ability to create and maintain a positive community image.\r\n Ability to define realistic goals and develop strategic opportunities for the betterment of the hospital.\r\n Ability to identify and resolve operational and administrative problems at both a strategic and functional level.\r\n Ability to communicate openly, effectively and frequently with multiple audiences.\r\n Ability to be diplomatic and possess a high degree of political savvy.\r\n Energetic, a good listener, with the ability to identify and resolve operational and administrative problems at both a strategic and functional level.\r\n Ability to produce quality results.\r\n Ability to be trustworthy and possess and utilize a core set of ethical values. \r\n Proficient knowledge to understand and apply the concepts, terminology, programs and processes unique to the healthcare industry. \r\n Proficient knowledge of all related acute care legal, regulatory and financial requirements. \r\n Proficient interpersonal and communication skills.\r\n Benefits\r\nAs a full time employee, Community Hospital Corporation offers a competitive salary, relocation package, along with incentive compensation plan, 401(k) savings and match, and a comprehensive health and welfare benefits package. \r\n\r\nAbout Morehouse General Hospital\r\nMorehouse General Hospital has a long history of serving Northeast Louisiana and Southeast Arkansas residents, opening in 1930 as a 19-bed acute care facility. 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This role is a fully flexible 1099 role–work only when you’d like to.\r\n\r\nWho We Are\r\nBerry Street is tackling America’s most comprehensive health crisis: food. More than half of Americans are struggling with their relationship with food, are clinically overweight, or experience a chronic condition linked to their diet. Nutrition therapy is clinically proven to make a difference, and most commercial health insurance plans cover it at $0 out-of-pocket.\r\nBerry Street empowers independent dietitians to accept insurance and grow thriving private practices by providing comprehensive credentialing, scheduling, referral, and technical support, as well as access to a vibrant, collaborative clinician community. We eliminate time-consuming admin so dietitians can focus on providing outstanding client care.\r\nWe believe everyone should have access to personalized nutrition therapy covered by insurance. Clinicians should be able to serve the communities they care about, not just those who can afford to pay out of pocket.\r\nDietitians working with Berry Street are committed to these pillars of high-quality care:\r\n Evidence-based: We provide quality care based on the latest clinical research. We actively track the quality of care to ensure better health outcomes and behavior change.\r\n Approachable: Through client education and nutrition therapy, we utilize a realistic, sustainable approach to create behavior change that lasts.\r\n Personalized: Our care plans are customized for each client based on their individual needs and concerns.\r\n Compassionate: We approach our work with compassion and empathy, working closely with our clients and their care teams to create meaningful change.\r\n Relationship-driven: You believe that successful behavior change comes from building deep, long-term relationships with your clients.\r\n \r\nWhat You’ll Do:\r\n Provide life-changing medical nutrition therapy via remote sessions to clients who fit your areas of specialty.\r\n Work from anywhere in the U.S. and choose the hours that fit your schedule best. 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You’re a pro at marketing yourself (or excited to learn how). You’re willing to invest time to build a relationship (ex. messaging, sharing materials, etc.) because that leads to better outcomes and more money in your pocket.\r\n Resourceful: You proactively continue your professional education, ask questions, and seek information to overcome hurdles to your work.\r\n Friendly, empathetic and focused on excellence: You approach every client interaction with empathy and a commitment to delivering an exceptional experience. You work to understand your clients’ unique goals and foster trust.\r\n \r\nWhat You’ll Need:\r\n Active Registration by the Commission on Dietetic Registration (CDR) OR Board for Certification of Nutrition Specialists (BCNS)\r\n For RDs: Licensed and in good standing in Nutrition/Dietetics in any state(s)\r\n For CNSs: Must hold at least one state license\r\n Licensed and in good standing in Nutrition/Dietetics in any state(s)\r\n Experience working with clients remotely via telehealth platforms and comfort working with technology\r\n Permanent residence within the United States\r\n Ability to build and maintain strong relationships with your clients and Referral partners\r\n Ability to quickly learn new methods and systems\r\n A minimum of 8 hours per week of ongoing availability\r\n Benefits\r\n Ability to define your own schedule\r\n Expedited credentialing: See insurance clients in as few as 30 days\r\n Intake & scheduling support: Simplified booking, onboarding, and eligibility verification\r\n End-to-end, guaranteed billing: Don't worry about denials or unpaid claims\r\n Access to EHR for efficient client management\r\n Charting Assistant: Time-saving tool that writes notes for you\r\n Dashboard for practice insights: View your schedule, clients, payouts, and more\r\n Peer community: Access to our private community of RDs and practice owners\r\n Dedicated support: Customer service support 7-days a week for you and your clients\r\n Workshops and professional development: Expert-led workshops on how to self-market your practice and other topics to uplevel your business\r\n Marketing & referrals: Promote your practice to thousands of potential clients\r\n ","price":"$85","unit":null,"currency":null,"company":"Workable","language":"en","online":1,"infoType":1,"biz":"jobs","postDate":"1756093176000","seoName":"remote-registered-dietitian-or-cns-flexible-hours-work-from-anywhere","supplement":null,"author":null,"originalPrice":null,"soldCnt":null,"topSeller":null,"source":1,"cardType":null,"action":"https://us.ok.com/en/city-louisiana/cate-general-practitioners/remote-registered-dietitian-or-cns-flexible-hours-work-from-anywhere-6349992659033712/","localIds":"31333","cateId":null,"tid":null,"logParams":{"tid":"c813073a-6d2f-49dd-8554-c72eaebfe01f","sid":"06766c88-7b8f-49e8-9354-373abb74ea9c"},"attrParams":{"summary":null,"employment":[{"icon":"https://sgj1.ok.com/yongjia/bkimg/8hvituaa__w72_h72.webp","name":"Job Type","value":"Part-time","unit":null},{"icon":"https://sgj1.ok.com/yongjia/bkimg/is8j0f44__w72_h72.webp","name":"Workplace type","value":"Remote","unit":null},{"icon":"https://sgj1.ok.com/yongjia/bkimg/ji66qqr0__w72_h72.webp","name":null,"value":"Baton Rouge,Louisiana","unit":null}]},"addDate":1756093176486,"categoryName":"General Practitioners","postCode":null,"secondCateCode":"healthcare-medical","kycTag":null,"pictureUrls":null,"isFavorite":false},{"category":"4000,4182,4189","location":"Bossier Parish, LA, USA","infoId":"6349984437542512","pictureUrl":"https://uspic1.ok.com/post/image/fc2dfa4f-dccd-4b5b-b64c-e4037dc4d35f.jpg","videos":null,"title":"Registered Nurse - Utilization Management","content":"Duties: The duties include, but are not limited to the following;\r\n\r\n Assist with orientation and training of other Medical Management staff and assist in providing, assessing, and improving a wide variety of customer service relations. Assists MTF officials to ensure Unit Effectiveness Inspection standards are met at the operational level.\r\n Assists in the development and implementation of a comprehensive Utilization Management plan/program for beneficiaries within MTF’s goals and objectives. This plan is based on using the 12-step approach as described in the DoD Medical Management Guide.\r\n Establish procedures for conducting reviews, including identification of types of healthcare services for which preauthorization or concurrent review will be required. Reviews previous and present medical care practices as needed for patterns, trends, or incidents of under or over utilization of hospital resources incidental to medical care provided to beneficiaries.\r\n Plans and performs reviews IAW established indicators and guidelines to provide quality cost-effective care. Ensures identified patient needs are addressed promptly with appropriate decisions. Provides timely, descriptive feedback regarding utilization review issues. Use the same generally accepted standards, norms, and criteria to review the quality, completeness, and adequacy of healthcare provided within the MTF, as well as its necessity, appropriateness, and reasonableness.\r\n Adhere to the established standardized DCS appeal process for resolving beneficiaries’ request for reconsideration of MTF denials of care based on medical necessity determinations in accordance with References (e) and (o). After following the directed methodology for appeals, the MTF will also adhere to its respective Service or joint commands’ process for intermediate notification, if any, prior to progressing from the internal to external level of appeals.\r\n Adhere to the MHS and Military Department’s or Joint Medical Commands’ referral management policies to manage internal and external referrals. Incorporate UM strategies as part of the referral management center’s routine processes. Ensure processes monitor, manage, and optimize demand or capacity (access).\r\n Collaborate with the PCMH team to develop performance measures and processes for clinically important conditions, as determined by the PCMH teams and MTF leadership. These clinically important conditions should include but may not be limited to high -cost, high-volume, or problem-prone diagnoses, procedures, services, and beneficiaries that utilize healthcare at higher rates than average and who may benefit from intervention and more intense care coordination. Performs data/metric collection. Analyzes data and prepares reports to describe resource utilization patterns. Briefs applicable data/slides to provider staff, executive staff, newcomers, as appropriate. Identifies areas requiring intensive management or areas for improvement.\r\n Maintains reports on which cases have been denied or received reduced third party payments and reports provider profiles to the MTF management for corrective action.\r\n Serves as a liaison with higher headquarters, TRICARE Regional Office, MTF national accreditation organization, professional organizations, and community health care facilities concerning Utilization Management.\r\n Participates in in-services and continuing education programs. Briefs applicable data/slides to provider staff, executive staff, newcomers, as appropriate.\r\n Establishes and maintains good interpersonal relationships with co-workers, families, peers, and other health team members. Submits all concerns through Utilization Management Director; be able to identify, analyze and make recommendations to resolve problems and situations regarding referrals. Ensure coordination and communication among all MM staff, including clinical and business personnel, to assure efficient, effective, quality care and services.\r\n Be productive and perform with minimal oversight and direction. Be able to independently identify, plan, and carry out projects with consideration for the goals and objectives of the TRICARE Utilization Management Element. Develops detailed procedures and guidelines to supplement established administrative regulations and program guidance. Recommendations are based upon analysis of work observations, review of procedures, and application of guidelines.\r\n \r\nSchedule:\r\nMonday - Friday, 9 hours between 7:00am and 5:00pm, with a one-hour lunch\r\nNo Weekends or Holidays\r\nRequirements\r\nMinimum Qualifications:\r\n* Education: Minimum ASN from an accredited college or university\r\n* Experience: One year of experience in Utilization Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six years of clinical nursing experience is preferred. \r\nMust possess experience in performing prospective, concurrent, and retrospective reviews to justify medical necessity for medical care to aid in collection and recovery from multiple insurance carriers. Review process includes Direct Care and Purchase Care System referrals, ward rounds for clinical data collection, contacting providers to inform them of dollars lost for missing documentation, and providing documentation for appeals resolution.  Possesses working knowledge of Ambulatory Procedure Grouping (APGs),Diagnostic Related Grouping (DRGs), International Classification of Diseases-Version 9(ICD), and Current Procedural Terminology-Version 4 (CPT-4) coding.\r\n* Licensure: Current, full, active, and unrestricted RN license from any state.\r\n* Life Support Certifications: AHA or ARC BLS Certification \r\n* Security: Must possess ability to pass a Government background check/security clearance.\r\n\r\nWe are an equal opportunity employer and a drug free workplace. 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General Practitioners in Louisiana
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General Practitioners
Louisiana
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Location:Louisiana
Category:General Practitioners
Chief Executive Officer, Morehouse General Hospital63499931479939120
Workable
Chief Executive Officer, Morehouse General Hospital
Community Hospital Corporation is seeking a dynamic and experienced Chief Executive Officer to lead Morehouse General Hospital, located in Bastrop, LA.  The CEO will be responsible for providing leadership, strategic guidance and management direction to all aspects of the hospital's operations while ensuring compliance with the hospital's mission, vision, values, goals, strategic direction, and applicable laws and regulations. The CEO is accountable for safe and quality patient care, developing and managing to a financially sound annual operating budget and long-term capital expenditure plan, hiring and retaining qualified and productive staff, managing risk, leading performance improvement, and maintaining effective relationships with Boards, medical staff, patients, employees, the community and the corporate office. Responsibilities Establishes and communicates a clear and compelling vision. All stakeholders should know the hospital’s mission, vision, and priorities. Works with the Board, senior management team, physicians and staff to develop, implement, and update strategies and opportunities for growth and improvement to support the hospital’s mission and respond to external and internal issues. Is responsible for the operational, strategic, financial and clinical performance of the hospital. Provides for a system of control which clearly identifies deviations from plans and budgets; assure periodic comparison of performance and/or results against established standards for objectives; assure corrective actions for deviation from plans so that annual results are in line with strategic goals. Maintains the hospital’s compliance with all regulatory and legal requirements. General Duties Keeps abreast of new legislative information that impacts the hospital and clinics. Establishes personal and professional credibility and an environment of trust, candor and genuine two way communications. Serves as a positive role model and mentor. Educates and promotes customer service throughout entire facility. Provides hospital operations coaching or mentoring. Attracts and retains physicians; maintain high levels of physician satisfaction. Works closely with the medical staff to ensure quality care, resolve conflicts and remove barriers to physicians admitting and referring to the hospital. Implements Board education and development programs through internal and external resources. Takes a proactive approach to managed care, healthcare reform and related issues.  Develops new business opportunities.  Active participation within the community, participates in and represents the hospital in professional, civic, and service organizations. Participates in meetings that affect the hospital. Upholds and supports Morehouse General Hospital and individual hospital’s mission, vision, values, goals and objectives. Supervisory Responsibilities Manages subordinate leader(s) who supervise employee(s) and/or supervise individual contributors as appropriate. Defines and communicates performance expectations.  Plans, assigns and directs work: follows up to assesses achievement of results.  Evaluates performance; coaches employees on an ongoing basis and takes developmental action as needed.  Rewards and recognizes notable performance. Addresses complaints, resolves problems and promptly addresses unacceptable behavior. Attracts, develops and retains talent. Carries out supervisory responsibilities in accordance with CHC's/hospital's policies and applicable laws.  Requirements Master's Degree in a healthcare related field or a BS in a healthcare related field with a business related masters, or the equivalent in education and experience. Minimum 7 years of executive leadership experience in a hospital or healthcare setting. CEO experience required. Leadership and experience in a small town environment with a track record of effective operational, financial, business development, and strategic skills.  Strong interpersonal and communication skills, with the proven ability to proactively develop positive relationships with physicians, employees, Board members and community leaders.  Exceptional critical thinking and decision-making abilities with a track record of leading staff to providing strong focus on patient safety and quality of care. Must have a track record of leading staff to provide safe quality patient care. Rural Health Care Clinic experience preferred. Skills and Knowledge Ability to enhance a quality of care environment, positive clinical outcomes and a high level of patient, physician and employee satisfaction. Ability to mentor and cultivate a talented management team. Ability to lead a high performing team and achieve results through others.  Ability to work with all levels of management and respecting all differences. Ability to create and maintain a positive community image. Ability to define realistic goals and develop strategic opportunities for the betterment of the hospital. Ability to identify and resolve operational and administrative problems at both a strategic and functional level. Ability to communicate openly, effectively and frequently with multiple audiences. Ability to be diplomatic and possess a high degree of political savvy. Energetic, a good listener, with the ability to identify and resolve operational and administrative problems at both a strategic and functional level. Ability to produce quality results. Ability to be trustworthy and possess and utilize a core set of ethical values.  Proficient knowledge to understand and apply the concepts, terminology, programs and processes unique to the healthcare industry.  Proficient knowledge of all related acute care legal, regulatory and financial requirements.  Proficient interpersonal and communication skills. Benefits As a full time employee, Community Hospital Corporation offers a competitive salary, relocation package, along with incentive compensation plan, 401(k) savings and match, and a comprehensive health and welfare benefits package. About Morehouse General Hospital Morehouse General Hospital has a long history of serving Northeast Louisiana and Southeast Arkansas residents, opening in 1930 as a 19-bed acute care facility. The hospital has grown to 49 beds, and today offers many of the services of a larger hospital in a metropolitan area including a wide range of inpatient and outpatient capabilities. Morehouse General Hospital is recognized by the American Hospital Association as a high-performing hospital for best practices. About Community Hospital Corporation: Community Hospital Corporation provides management services to Morehouse General Hospital. Here CHC puts its purpose into practice by guiding, supporting and enhancing our mission and strengthening community hospitals and healthcare providers across the country. Based in Plano, Texas, CHC provides the resources and experience community hospitals need to improve quality outcomes, patient satisfaction and financial performance. For more information about CHC, please visit the company website at www.chc.com CHC is a tobacco and drug free workplace. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Bastrop, LA 71220, USA
Negotiable Salary
Registered Nurse - UM/UR63499795376257121
Workable
Registered Nurse - UM/UR
Cooperidge Consulting Firm is seeking an experienced Registered Nurse (RN) specializing in Utilization Management (UM) and Utilization Review (UR) to join the team of one of our DoD clients. In this role, you will assess patient care, collaborate with healthcare providers, and ensure compliance with quality standards and policies. This position is essential for promoting efficient healthcare delivery and optimal patient outcomes. Key Responsibilities: Conduct comprehensive reviews of clinical records for appropriateness and necessity of care Collaborate with healthcare teams to ensure coordinated patient care Facilitate care transitions and discharge planning processes Monitor healthcare services to ensure compliance with internal and external regulations Educate patients and families about care management processes and available resources Schedule: Monday through Friday 9-hour workdays between 7:00 AM and 5:00 PM One-hour lunch break No weekends or holidays Requirements ASN degree from an accredited college or university AHA or ARC BLS Certification  Minimum of 3 years of clinical nursing experience, with at least 1 year in Utilization Management or Utilization Review Certification in Utilization Review or Case Management preferred (but not required) Strong analytical and critical thinking skills Excellent communication and interpersonal skills Ability to work effectively in a fast-paced, team-oriented environment Must possess ability to pass a Government background check/security clearance. Benefits Health Care Plan (Medical, Dental & Vision) Retirement Plan (401k, IRA) Life Insurance (Basic, Voluntary & AD&D) Paid Time Off (Vacation, Sick & Public Holidays) Family Leave (Maternity, Paternity) Short Term & Long Term Disability Training & Development Wellness Resources Annual CME Stipend and License/Certification Reimbursement
Shreveport, LA, USA
Negotiable Salary
Remote Registered Dietitian or CNS - Flexible Hours, Work from Anywhere63499926590337122
Workable
Remote Registered Dietitian or CNS - Flexible Hours, Work from Anywhere
Location: Fully Remote Schedule: Flexible Compensation: Up to $85 per hour Job Type: Full-time, Part-time About the Role We’re looking for entrepreneurial, empathetic Registered Dietitians (RDs) and Certified Nutrition Specialists (CNSs) licensed in any state to help us bring medical nutrition therapy (MNT) to all. This role is a fully flexible 1099 role–work only when you’d like to. Who We Are Berry Street is tackling America’s most comprehensive health crisis: food. More than half of Americans are struggling with their relationship with food, are clinically overweight, or experience a chronic condition linked to their diet. Nutrition therapy is clinically proven to make a difference, and most commercial health insurance plans cover it at $0 out-of-pocket. Berry Street empowers independent dietitians to accept insurance and grow thriving private practices by providing comprehensive credentialing, scheduling, referral, and technical support, as well as access to a vibrant, collaborative clinician community. We eliminate time-consuming admin so dietitians can focus on providing outstanding client care. We believe everyone should have access to personalized nutrition therapy covered by insurance. Clinicians should be able to serve the communities they care about, not just those who can afford to pay out of pocket. Dietitians working with Berry Street are committed to these pillars of high-quality care: Evidence-based: We provide quality care based on the latest clinical research. We actively track the quality of care to ensure better health outcomes and behavior change. Approachable: Through client education and nutrition therapy, we utilize a realistic, sustainable approach to create behavior change that lasts. Personalized: Our care plans are customized for each client based on their individual needs and concerns. Compassionate: We approach our work with compassion and empathy, working closely with our clients and their care teams to create meaningful change. Relationship-driven: You believe that successful behavior change comes from building deep, long-term relationships with your clients. What You’ll Do: Provide life-changing medical nutrition therapy via remote sessions to clients who fit your areas of specialty. Work from anywhere in the U.S. and choose the hours that fit your schedule best. This is a 1099-Contractor position. Create personalized, evidence-based nutrition plans tailored to client needs and preferences. Provide resources and educational materials to clients to support their health journey. Strengthen client relationships to improve retention. Use online telehealth tools to track progress, answer client questions, etc. Stay current with the latest research and trends in nutrition and wellness. Collaborate with other healthcare professionals if applicable to ensure comprehensive care for clients with complex health needs. Maintain timely, accurate records of client sessions and progress. Requirements You’ll be a good fit for Berry Street if you're: A self-starter: You know how to take initiative and work independently and tirelessly for your clients and private practice. Adaptable: You’re comfortable in changing environments. Growth-Oriented: You look to broaden your expertise and confidently support clients beyond your specialty. Entrepreneurial: You’re excited to take part in growing your client base and ultimately, a sustainable practice. You’re a pro at marketing yourself (or excited to learn how). You’re willing to invest time to build a relationship (ex. messaging, sharing materials, etc.) because that leads to better outcomes and more money in your pocket. Resourceful: You proactively continue your professional education, ask questions, and seek information to overcome hurdles to your work. Friendly, empathetic and focused on excellence: You approach every client interaction with empathy and a commitment to delivering an exceptional experience. You work to understand your clients’ unique goals and foster trust. What You’ll Need: Active Registration by the Commission on Dietetic Registration (CDR) OR Board for Certification of Nutrition Specialists (BCNS) For RDs: Licensed and in good standing in Nutrition/Dietetics in any state(s) For CNSs: Must hold at least one state license Licensed and in good standing in Nutrition/Dietetics in any state(s) Experience working with clients remotely via telehealth platforms and comfort working with technology Permanent residence within the United States Ability to build and maintain strong relationships with your clients and Referral partners Ability to quickly learn new methods and systems A minimum of 8 hours per week of ongoing availability Benefits Ability to define your own schedule Expedited credentialing: See insurance clients in as few as 30 days Intake & scheduling support: Simplified booking, onboarding, and eligibility verification End-to-end, guaranteed billing: Don't worry about denials or unpaid claims Access to EHR for efficient client management Charting Assistant: Time-saving tool that writes notes for you Dashboard for practice insights: View your schedule, clients, payouts, and more Peer community: Access to our private community of RDs and practice owners Dedicated support: Customer service support 7-days a week for you and your clients Workshops and professional development: Expert-led workshops on how to self-market your practice and other topics to uplevel your business Marketing & referrals: Promote your practice to thousands of potential clients
Baton Rouge, LA, USA
$85
Registered Nurse - Utilization Management63499844375425123
Workable
Registered Nurse - Utilization Management
Duties: The duties include, but are not limited to the following; Assist with orientation and training of other Medical Management staff and assist in providing, assessing, and improving a wide variety of customer service relations. Assists MTF officials to ensure Unit Effectiveness Inspection standards are met at the operational level. Assists in the development and implementation of a comprehensive Utilization Management plan/program for beneficiaries within MTF’s goals and objectives. This plan is based on using the 12-step approach as described in the DoD Medical Management Guide. Establish procedures for conducting reviews, including identification of types of healthcare services for which preauthorization or concurrent review will be required. Reviews previous and present medical care practices as needed for patterns, trends, or incidents of under or over utilization of hospital resources incidental to medical care provided to beneficiaries. Plans and performs reviews IAW established indicators and guidelines to provide quality cost-effective care. Ensures identified patient needs are addressed promptly with appropriate decisions. Provides timely, descriptive feedback regarding utilization review issues. Use the same generally accepted standards, norms, and criteria to review the quality, completeness, and adequacy of healthcare provided within the MTF, as well as its necessity, appropriateness, and reasonableness. Adhere to the established standardized DCS appeal process for resolving beneficiaries’ request for reconsideration of MTF denials of care based on medical necessity determinations in accordance with References (e) and (o). After following the directed methodology for appeals, the MTF will also adhere to its respective Service or joint commands’ process for intermediate notification, if any, prior to progressing from the internal to external level of appeals. Adhere to the MHS and Military Department’s or Joint Medical Commands’ referral management policies to manage internal and external referrals. Incorporate UM strategies as part of the referral management center’s routine processes. Ensure processes monitor, manage, and optimize demand or capacity (access). Collaborate with the PCMH team to develop performance measures and processes for clinically important conditions, as determined by the PCMH teams and MTF leadership. These clinically important conditions should include but may not be limited to high -cost, high-volume, or problem-prone diagnoses, procedures, services, and beneficiaries that utilize healthcare at higher rates than average and who may benefit from intervention and more intense care coordination. Performs data/metric collection. Analyzes data and prepares reports to describe resource utilization patterns. Briefs applicable data/slides to provider staff, executive staff, newcomers, as appropriate. Identifies areas requiring intensive management or areas for improvement. Maintains reports on which cases have been denied or received reduced third party payments and reports provider profiles to the MTF management for corrective action. Serves as a liaison with higher headquarters, TRICARE Regional Office, MTF national accreditation organization, professional organizations, and community health care facilities concerning Utilization Management. Participates in in-services and continuing education programs. Briefs applicable data/slides to provider staff, executive staff, newcomers, as appropriate. Establishes and maintains good interpersonal relationships with co-workers, families, peers, and other health team members. Submits all concerns through Utilization Management Director; be able to identify, analyze and make recommendations to resolve problems and situations regarding referrals. Ensure coordination and communication among all MM staff, including clinical and business personnel, to assure efficient, effective, quality care and services. Be productive and perform with minimal oversight and direction. Be able to independently identify, plan, and carry out projects with consideration for the goals and objectives of the TRICARE Utilization Management Element. Develops detailed procedures and guidelines to supplement established administrative regulations and program guidance. Recommendations are based upon analysis of work observations, review of procedures, and application of guidelines. Schedule: Monday - Friday, 9 hours between 7:00am and 5:00pm, with a one-hour lunch No Weekends or Holidays Requirements Minimum Qualifications: * Education: Minimum ASN from an accredited college or university * Experience: One year of experience in Utilization Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six years of clinical nursing experience is preferred.  Must possess experience in performing prospective, concurrent, and retrospective reviews to justify medical necessity for medical care to aid in collection and recovery from multiple insurance carriers. Review process includes Direct Care and Purchase Care System referrals, ward rounds for clinical data collection, contacting providers to inform them of dollars lost for missing documentation, and providing documentation for appeals resolution.  Possesses working knowledge of Ambulatory Procedure Grouping (APGs),Diagnostic Related Grouping (DRGs), International Classification of Diseases-Version 9(ICD), and Current Procedural Terminology-Version 4 (CPT-4) coding. * Licensure: Current, full, active, and unrestricted RN license from any state. * Life Support Certifications: AHA or ARC BLS Certification  * Security: Must possess ability to pass a Government background check/security clearance. We are an equal opportunity employer and a drug free workplace. All applicants selected for employment are required to submit to a background check and pre-employment drug test.  Benefits Excellent Compensation & Exceptional Comprehensive Benefits: * Paid Vacation, Paid Sick Time, Plus 11 Paid Federal Holidays!  * Medical/Dental/Vision, STD/LTD/Life, Health Savings Account available, and more! * Annual CME Stipend and License/Certification Reimbursement! * Matching 401K! Base salary: $32.00 - $44.00/hr depending on experience
Bossier Parish, LA, USA
$32-44
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