Join the pioneering healthcare team at Sprinter Health as a Family Nurse Practitioner! Revolutionize healthcare delivery by conducting virtual wellness visits to patients in their homes. Utilize your expertise to offer virtual adult and/or pediatric wellness visits and health assessments. Be dependable, professional, and compassionate while delivering exceptional care.
Revolutionize healthcare delivery by conducting virtual wellness visits directly to patients in the comfort of their homes. As a Nurse Practitioner with Sprinter Health, you'll leverage your medical expertise to offer healthcare services such as virtual adult and/or pediatric wellness visits and health assessments. Deliver exceptional customer service and maintain high-quality standards.
The Remote Clinical Denials RN reviews, analyzes, and appeals clinical denials from insurance companies and third-party payers. A strong clinical background, knowledge of medical necessity criteria, and expertise in appealing denied claims are required. Responsibilities include conducting denial root-cause analysis, retrospective medical record reviews, and collaborating with hospital staff.
The Care Manager is responsible for the coordination of services for members who meet established criteria, with an emphasis on education/self-management and promoting quality care and cost-effective outcomes. The Care Manager uses a collaborative process to assess Member needs, review options for services and resources, develop and implement a plan of care, coordinate resources, monitor progress, evaluate Member status, discharge Members, and fully document the individualized member care management process and outcome.
The Concurrent Utilization Review (UR) Nurse conducts real-time clinical reviews to ensure the medical necessity and appropriateness of healthcare services provided to members under a managed care health plan, assessing inpatient admission and continued stays, coordinating with healthcare providers, facilitating communication with payers, ensuring compliance with health plan policies and clinical guidelines, and collaborating with the Medical Director and clinical leadership for complex cases, denials, and escalated reviews.
Performs the delivery of care to participants and provides regional support to per-diem Mobile Research Nurses. Ensures the professional delivery of patient care in compliance with all national/local regulations, Good Clinical Practice, and Standard Operating Procedures. Adaptable Problem-solver Collaborative Clinically skilled.
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
Looking for an experienced Registered Nurse (RN) to work as a Clinical Nurse to support our existing and growing markets. The role will report to the Clinical Director. The ideal candidate will be an experienced nurse with demonstrated ability to effectively interact with remote teams, identify and create solutions.
The Patient Support Nurse will facilitate a successful patient journey to and while on therapy by providing care coordination, education, and psychosocial support, provide medication and disease state education, and provide clinical feedback to enhance the clinical portion of patient support programs.
Medically manage assigned caseload and, by applying clinical expertise, ensure individuals receive appropriate healthcare in order to return to work and normal activity in a timely and cost-effective manner. Caseload may include catastrophic/complex medical/disability cases, lost time, and/or medical only claims. Also act as a clinical resource for field claim partners.