Sentences with phrase «utilization management guidelines»

• Knowledge and experience in the design, implementation and analysis of health care quality and cost data studies for quality improvement and appropriate cost - containment, resource utilization analysis, physician profiling, HEDIS, NCQA and QARR reporting • Microsoft Office Professional Suite (Word, Excel, Access, Outlook) • Proficient in application of Utilization Management Guidelines, including Milliman, Robertson and InterQual

Not exact matches

â $ cents Use expert skills to study work methods, administrative guidelines, procedures, utilization of human resources, work assignments, delegations of authority, management controls, information and documentation systems, etc. â $ cents Analyze and evaluate findings and recommend more efficient, effective and economical ways to meet workload and program goals.

Black Nurses Rock LLC membership 2016 to current Chi Eta Phi Nursing Sorority... Summary Registered Nurse for 30 years with extensive background in Case Management, Utilization... Medicare and Medicaid guidelines.

Non-Profit Program and Operations Coordinator — Duties & Responsibilities Lead through example with consistent work ethic, attitude, and professionalism, while executing various program administration functions, overseeing operations and ensuring both efficient organizational communications and processes Collaborate in all phases of strategic planning with other members of management team, including program mission, marketing and public relations, vendor and volunteer management, member services and systems implementation Demonstrate leadership with respect to program direction, fundraising strategies and project management Provide continuous assessment of key considerations, potential issues, and the utilization of available resources, while furnishing oversight and guidance regarding effective donor recruitment and recognition strategies Perform needs - based and situational assessments of policies and procedures to evaluate program effectiveness, improve operational efficiency, manage and reduce costs, and promote both staff and member satisfaction Utilize talent among team members with focused training efforts, effective collaboration and the promotion of a performance - based work environment that leverages individual talents for group benefit Employ support staff to aid in effective marketing, relations, administration and program operations, delegating important tasks and assignments while providing timely follow - up to ensure task completion Facilitate the effective execution of all related administrative and financial aspects of non-profit management, while analyzing and presenting important information to executives, stakeholders and other relevant parties Ensure the organization and maintenance of relevant information in confidential, secure, and efficient manner as well as adherence to all stated laws, statutes, policies, procedures and guidelines with application in the non-profit arena Support the creation and implementation of organizational marketing and operations strategies while tracking performance versus internal and external benchmarks, focusing on both program growth as well as cost management Develop and maintain a strong working knowledge of related products, services, techniques and relevant tools

Customer Service and Administration Duties & Responsibilities Interact with customers in a professional manner to improve the client experience, resolving queries and issues in a timely and professional fashion while making all customer needs the top priority Implement quality assurance processes to ensure administrative accuracy and promote operational efficiency Assist in the execution of needs - based client assessment to facilitate successful product / service utilization Collaborate and communicate effectively with all departments and members of company management, acting as a liaison between customers and all staff members as well as representing institutions within the community Generate referrals and consistent repeat business through effective service and timely follow - up Meet and exceed marketing and sales strategies while tracking progress versus established benchmarks Maintain a strong working knowledge of company products and services, respective marketplace, competitor strategies, industry regulations, and other pertinent information, applying all knowledge to related job functions Provide relevant guidance / leadership to new staff training efforts and coaching, consistently leading by example Oversee critical document control and management, maintaining all files in an organized manner Perform continuous assessment of client service operations while furnishing oversight and guidance regarding effective customer service and issue resolution techniques Adhere consistently to all established policies, guidelines, procedures, related laws, and other related constraints Utilize various technology applications to drive customer service and administrative processes Assist management team and senior department members with various other duties as assigned