Fully RemoteDescription:Position SummaryProvide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issuesDutiesDetermines medical necessity/ appropriatenessFacilitates optimal outcomesIdentifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrance's and initiation of corrective actionEducates/ empowers customers to ensure compliance, satisfaction and promote patient advocacyOptimize total costsImplementation and evaluation of policy based on usage and program directivesEducate/empower colleagues at all levels to enable decision making at most appropriate levelExperienceMinimum 1 year of relevant experienceEducationHigh School Diploma/GEDImportant Skills:Must be proficient with MS Office - with excel, should be comfortable using filters to sort through spreadsheet data.Outbound call experience is a major plus as these hires will be primarily on outbound calls with members.Notes:Mon-Fri 8:00-5:00 ESTFully remote (never coming onsite)VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
Description:Position SummaryProvide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issuesDutiesDetermines medical necessity/ appropriatenessFacilitates optimal outcomesIdentifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrance's and initiation of corrective actionEducates/ empowers customers to ensure compliance, satisfaction and promote patient advocacyOptimize total costsImplementation and evaluation of policy based on usage and program directivesEducate/empower colleagues at all levels to enable decision making at most appropriate levelExperienceMinimum 1 year of relevant experienceEducationHigh School Diploma/GEDImportant Skills:Must be proficient with MS Office - with excel, should be comfortable using filters to sort through spreadsheet data.Outbound call experience is a major plus as these hires will be primarily on outbound calls with members.Notes:Mon-Fri 8:00-5:00 ESTFully remote (never coming onsite)
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