Responsibilities

• Oversee and ensure the effective delivery of services to members receiving private duty nursing (PDN) services.
• Resolve issues and facilitate communication between cross-functional teams, including service providers and finance teams.
• Maintain meticulous records and tracking mechanisms to monitor service delivery and compliance with contract requirements.
• Analyze data to identify trends, issues, and areas for improvement in service performance.
• Coordinate with case management teams to ensure alignment of services and regulatory compliance.
• Develop and implement strategies to mitigate financial risks associated with high-acuity members.
• Prepare detailed reports and presentations for stakeholders, ensuring clarity and actionable insights.

Requirements

• Bachelor's degree in a related field or equivalent work experience.
• Strong problem-solving skills and the ability to think independently.
• Proficient in Microsoft Excel, with experience in creating complex tracking systems.
• Familiarity with healthcare-related systems such as claims, encounter, or case management systems.
• Excellent communication skills, both verbal and written, to facilitate effective collaboration.
• Detail-oriented with a strong emphasis on reporting and tracking performance metrics.
• Experience in project management or a related role is preferred.

Benefits

• Competitive salary and comprehensive benefits package.
• Opportunity to work remotely, with flexibility in work hours.
• Professional development opportunities to advance your career.
• Supportive work environment that values collaboration and innovation.
• Access to resources and tools to help you succeed in your role.