Review comprehensive diagnostic evaluations to ensure valid diagnosis has been given Obtain clinical information from providers on Applied Behavior Analysis requests for treatment Determine if additional clinical treatment sessions for Applied Behavior Analysis are medically necessary in accordance with appropriate level of care guidelines Manage outpatient cases througho

Provide supervision to department staff, works independently, and collaborates with Physician and RN leadership on relevant clinical issues Recruit and retain talented staff and ensure proper training, resource allocation and develop standards to monitor and evaluate staff performance Implement and maintain clinical and business policies and procedures Ensures customer sa

Provider Compensation and Incentive Calculations Perform monthly and quarterly calculations of provider productivity and quality initiatives that adjust their compensation Develop reporting results and present to Sr. Management and operations leadership Presenting and educating physicians on compensation plans and incentives Continuous financial analysis and modeling of e

Packaging patient deliveries for shipments via FedEx and Courier Stocking medications and supplies Packaging and pulling medications and supplies Assisting with inventory/purchasing tasks Willingness to learn aseptic technique, compounding practices, and cleanroom sterility This role is equally challenging and rewarding. You'll need to work within multiple computer system

Examines, diagnoses and treats patients for acute injuries, infections, and illnesses Counsels and educates patients and families about acute and chronic conditions or concerns Documents items such as chief complaint, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment and plan Formulates diagnostic and treatment p

Verify prescriptions and prescription data entered into the pharmacy computer system for accuracy Oversees the activities of pharmacy technicians and inventory personnel Organizes workload, sets priorities, completes assignments in a timely manner and utilizes resources appropriately while complying with department program standards Work in the fulfillment area to provide

Identify appropriate assignment of CPT and ICD 10 Codes for outpatient surgery, observation, emergency, and ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Understand the Medicare Ambulatory Payment Classification (APC) codes Abstract additional data elements during the Chart Review proc

Examines, diagnoses and treats patients for acute injuries, infections, and illnesses Counsels and educates patients and families about acute and chronic conditions or concerns Documents items such as chief complaint, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment and plan Formulates diagnostic and treatment p

At OptumCare, we share what might be seen as a surprisingly simple goal making the health system work better for everyone. We look for people who relentlessly push themselves to go farther. For these high performers, a position on a team at OptumCare is a natural fit. We offer more than the talent, resources and can do culture we offer a place to improve the lives of othe

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. This position will be located in one clinic with the potential to expand to one other site in the West Valley. You will be working in alignme

Receive and review all correspondence daily. Follow up on assigned insurance accounts. Assist all hospital employees with any needs that arise. Our ideal candidate is an adept communicator; deadline oriented, and self motivated, with excellent follow up and customer service skills. You'll be rewarded and recognized for your performance in an environment that will challeng

Identify appropriate assignment of CPT and ICD 10 Codes for outpatient Acute Interventional Radiology services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits Understand the Medicare Ambulatory Payment Classification (APC) code

Verifies insurance eligibility and benefits on all assigned accounts using electronic verification systems or by contacting payers directly to determine level of insurance coverage. When contacting payers directly, utilizes approved scripting. Obtains referral, authorization and pre certification information and documents this information in system. Identifies outstanding

Manage overall performance of assigned Clinic location across assigned market including cost, quality, and patient satisfaction Partner with integration teams to ensure successful practice onboarding and integration, and appropriate resource allocation Support provider recruitment efforts in the market and play a key role in the successful onboarding and integration of ne

Provides leadership to and is accountable for the performance of Clinical Quality Consultants and data abstractors Direction and guidance on network clinical quality performance and improvement Provide analytical interpretation of quality performance and support business plan development to measure and improve performance Be the subject matter expert for quality related a