Telecommute / Work From Home

Medical Management Consultant

kirstyn — Thu, 19 Jan 2012 16:50:42 -0500

The Medical Management Consultant organizes and plans operational activities associated with regional medical directors, supporting Participating Physician Group (PPG) performance improvement by acting as liaison between Priority Performance Medical Groups and Health Net of California Medical Management in order to maintain excellent health care and quality performance standards. This position is responsible developing and managing relationships with clients, designing care plans and programs, educating and training medical group staff and Health Net associates, and

Medical Program Manager - TELECOMMUTING OPTION!

kirstyn — Thu, 19 Jan 2012 16:26:56 -0500

The Medical Program Manager monitors and evaluates PPG/IPA (Participating Physician Group/Independent Practice Association) utilization management, quality improvement, and educational programs to ensure they meet Health Net's contractual and regulatory requirements. This position also acts as a consultant to medical groups to assist them in the design and enhancement of their UM/QI (Utilization Management/Quality Improvement) programs.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Appeals & Grievance RN Clinical Specialist II - TELECOMMUTING OPTION!

kirstyn — Thu, 19 Jan 2012 16:14:17 -0500

The Appeals and Grievance Clinical Specialist II is responsible for performing advanced and complicated case review of the appropriateness of medical care and service provided to members requiring considerable clinical judgment, independent analysis and detailed knowledge of managed health care, departmental procedures and clinical guidelines. Activities include case preparation, research and overturn determinations. This position identifies system issues that result in failure to provide appropriate care to members or failure to meet service expectations.

Manager, Health & Wellness Vendor Management - TELECOMMUTING OPTION!

kirstyn — Tue, 20 Dec 2011 09:55:51 -0500

The RN Manager, Health & Wellness Vendor Management is accountable for providing leadership and strategic support to Vendor Operations Management. This position will manage a department charged with managing the operational aspects of HN relationships with its third party vendors and risk entities. Supports the Decision Power Health and Wellness Program.

Saint Luke's Health System − The Best Place to Get Care and The Best Place to Give Care.

kirstyn — Mon, 05 Dec 2011 12:19:04 -0500

Case Manager/Care Coordinator II - TELECOMMUTING OPTION!

kirstyn — Fri, 14 Oct 2011 10:29:15 -0400

The Case Manager/Care Coordinator II is responsible for the coordination of services and cost effective management of health care resources to meet individual members' health care needs and promote positive health outcomes. Acts as a member advocate and a liaison between providers, members and HN to seamlessly integrate complex services. Case Management services are generally focused on members who fall into one or more high risk or high cost groups and require significant clinical judgement, independent analysis, critical-thinking, detailed knowledge of

Dedicated to Nurses who are dedicated to children. Join the Nemours team.

kirstyn — Mon, 26 Sep 2011 16:44:03 -0400

Dedicated to Nurses who are dedicated to children. Join the Nemours team.

kirstyn — Mon, 26 Sep 2011 16:12:47 -0400

Dedicated to Nurses who are dedicated to children. Join the Nemours team.

kirstyn — Mon, 26 Sep 2011 16:10:37 -0400

Dedicated to Nurses who are dedicated to children. Join the Nemours team.

kirstyn — Mon, 26 Sep 2011 16:07:16 -0400

Join our compassionate team of nurses: PALOMAR POMERADO HEALTH, the first CA health system to receive ANCC Magnet® Recognition.

kirstyn — Wed, 03 Aug 2011 16:49:28 -0400

Graduate Nursing Faculty Positions

kirstyn — Wed, 20 Jul 2011 11:03:07 -0400

Responsibilities:
Our Department of Nursing, which houses the program, is seeking creative, energetic and seasoned faculty members to fill multiple roles in the online graduate programs. The successful candidate will join a vibrant faculty to help design and implement our online program using a learning management system that supports high-level student engagement through synchronous and asynchronous sessions.

Care Manager II - Post Service Review - 11000820

kirstyn — Tue, 24 May 2011 15:17:39 -0400

JOB SUMMARY: CARE MANAGER II - POST-SERVICE Review - TELECOMMUTING OPTION!

HEALTH NET IS GROWING! MULTIPLE POSITIONS!

Clinical Specialist II - Appeals & Grieveance - 11000823

kirstyn — Fri, 13 May 2011 17:28:24 -0400

JOB SUMMARY: CLINICAL SPECIALIST II - Appeals & Grievance - Telecommuting Option MULTIPLE POSITIONS!

Medical Program Manager - 11000725

kirstyn — Fri, 13 May 2011 17:21:50 -0400

JOB SUMMARY: MEDICAL PROGRAM MANAGER - Telecommuting Option!
The Medical Program Manager monitors and evaluates PMG/IPA (Participating Medical Group/Independent Practice Association) utilization management, quality improvement, and educational programs to ensure they meet Health Net's contractual and regulatory requirements. This position also acts as a consultant to medical groups to assist them in the design and enhancement of their UM/QI (Utilization Management/Quality Improvement) programs.

ESSENTIAL DUTIES AND RESPONSIBILITIES: