of Position We are seeking a talented Grievance & Appeals Specialist who will be responsible for responding to written/verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with NCQA, CMS, State, and other regulations. They will process appeals and grievances to facilitate the accurate administration of benefits and clinical

of Job Provide care management, as part of a multi disciplinary care team, that includes care coordination, performing telephonic or face to face assessments of members' health care needs, identifying gaps in care and needed support, administering/coordinating implementation of interventions. Support and enable members to manage their physical, environmental and psycho soc

Make an Impact! Provide general nursing care to patients as well as care coordination in collaboration with other members of the care team. Ensure practices of the care team are in accordance with nursing standards local, state, and federal guidelines, and organizational policy. Develop and Enhance your Leadership Skills! Provide clinical supervision to Licensed Practical

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

of Position Assist the Manager, Nursing in the management and education of care team members providing professional nursing care to patients. Proactively support efforts to ensure that standards for quality of care, patient satisfaction, and patient safety are maintained, as established by AdvantageCare Physicians including best practices, regulatory requirements, and clin

Participates and supports the health team in direct patient care. Performs duties involving direct patient care as assigned by the physician within the framework of the New York State Nurse Practice Act and AdvantageCare Physicians' policies and procedures. Identifies physical, behavioral, and emotional characteristics typical for the age group of the patient receiving ca

of Position Provide professional nursing care to patients and proactively support efforts to ensure that standards for patient satisfaction, patient safety, and quality of care are maintained, as established by AdvantageCare Physicians. Primary liaison between patients, staff and physicians and support the Advanced Care Model. Organize and provide clinical supervision to t