Establish and maintain positive clinical rapport with patients and their families, working closely with them in the provision of infusion therapy, education related to self care and self administration, and clinical monitoring of patient response to therapy Assess patient appropriateness for infusion therapy, including safety of the environment, availability of caregiver

Manage administrative intake of members Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review

Meet the Data Engineering needs of the Optum Analytics Life Sciences business as part of the Life Science Data Factory team Perform all phases of data engineering including requirements analysis, design, development and testing Design and implement features in collaboration with business and IT stakeholders Design reusable workflows, components, frameworks and libraries D

Create disruption reports for prospect clients Support sales team efforts to implement new clients Partner with IT in implementing new methodology into existing reporting Anticipates customer needs and proactively develops solutions to meet them Serves as a key resource on complex and/or critical issues Perform quality review of output provided Provides explanations and i

Owns implementation and vendor management for population health programs and affordability programs in new markets, including participating in selecting appropriate vendors for population health initiatives; developing business requirements; and managing vendor performance and effectiveness Provide Operational Readiness support for the implementations and any identified n

Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorize the appropriate payment or refers claims to investigators for further review. Conduct data entry and re work; analyzes and identifies trends and provides reports as necessary. Analyze and identify trends and provide reports as necessary Consiste

Patient Registration Greets patients and/or visitors to the facility in a courteous manner Conducts interviews to obtain relevant demographic and insurance data; obtains appropriate signatures on medical, legal, and financial forms Provides copies and interpretation of Hospital policies and regulations to patients including, but not limited to visiting hours, patient righ

Regular contact with provider groups to collect clinical data Support patients in scheduling home visits Ensure that Landmark has all documentation available regarding patient conditions Support Landmark providers and Nurse Care Managers with operational and clinical tasks Handle escalated patient issues, ensuring the appropriate resources are involved Follow triage proto

Infusion remit management assistance Attend/participate on Unapplied Remit Management conference calls Assist in obtaining outstanding remits for challenging payer/portals or restricted portals Focus on electronic remittance automation Research, identify, and upgrade paper payments to electronic funds transfer Practice attention to detail to best ensure correct/complete e

Analyzes and applies denials to third party carriers in all media types. Complies with departmental Business Rules and Standard Operating Procedures Focuses efforts on decreasing the Accounts Receivable, increasing cash, and/or reducing bad debt. Interprets explanation of benefits for appropriate follow up action. Utilizes automation tools to verify eligibility, claim sta

Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial

Responsible for overseeing and participating in day to day clinical care of patients Performs patient intake process (vital signs, history) Coordinate patient care as directed by physicians, company standards and policies Performs clinical procedures (injections, ear lavage) Assists the providers with invasive procedures and minor surgeries Maintains clinical logs (autocl

Assist physicians and nursing personnel with injections, EKGs, phlebotomy and other patient care procedures Maintain established quality control standards Record and process patient care documentation quickly and accurately Coordinate patient care as directed by physicians, company standards and policies Organize, stock and clean exam and treatment rooms and sterilize ins

Supervises multiple client related assignments concurrently. Attends client meetings via WebEx, Teams, Zoom or conference call. Communicates and documents client requests/updates to all internal stakeholders. Acts as conduit between March Vision Care and client to schedule meetings, track questions/requirements, relay questions/answers. Tracks the progress of all objectiv

Gathering and analyzing data Interpreting gathered data Submitting reports to the relevant business teams and help translate the business requirements to internal teams Finding patterns and trends in the analyzed data Helping the management teams draw business goals and needs Establishing new data gathering and analysis techniques You'll be rewarded and recognized for you