Evaluate and pre-certify medical requests such as hospital stays and surgeries using evidence-based guidelines. Coordinate with providers and participants to ensure medically necessary care and refer patients to case management services.
HealthCheck360
7 Remote Job Openings at HealthCheck360
Provide telephonic and e-coaching to help individuals set and achieve goals related to fitness, nutrition, and stress management. Review Health Risk Assessment results to develop personalized strategies for positive lifestyle changes.
Provide telephonic and e-coaching to help individuals set and achieve goals regarding fitness, nutrition, weight, and stress management. Review Health Risk Assessment results to develop personalized strategies for positive lifestyle changes.
The Utilization Management Assistant handles first-level calls for HealthCheck360 participants and evaluates certification requests based on group requirements. They are responsible for reviewing medical records and coordinating with providers to ensure cost-effective care.
The assistant handles first-level calls for Utilization Review and evaluates certification requests based on group requirements. They coordinate with healthcare providers and review medical records to ensure cost-effective care according to clinical guidelines.
The RN Case Manager will assess, plan, and coordinate care for assigned consumers to ensure quality and cost-effective treatment. They will also serve as a liaison between consumers and benefit administrators while providing telephonic case management and utilization review.
The RN Case Manager will assess, plan, and coordinate care for consumers to ensure quality outcomes and cost-effective treatment. They will also provide telephonic case management, utilization review, and serve as a liaison between consumers and benefit administrators.
