Reviews medication orders and evaluates appropriateness and completeness of orders with consideration given to the special needs and behaviors of the specific age group served Verifies all prescriptions not directly received from the prescriber or physician's agent Provide oversight of the safety; appropriateness, and effectiveness of the pharmaceutical care provide to pa

Works with the providers and clinic staff to identify patients at high risk Supports longitudinal care of the patient with chronic care conditions by Performing assessment of health conditions Performing medication reconciliation Conducting Motivational Interviewing and Self Management Goal setting Providing patient education, creating referrals to appropriate agencies an

Understand the Culture and Values of Southwest Medical and OptumCare Learn about Population Management and the way it is implemented at Southwest Medical Get to know Southwest Medical Providers and Staff Mentoring by Southwest Medical Physicians Opportunity to do elective rotation with Southwest Medical Attend Quarterly provider meetings and monthly department meetings wh

Performs medication review for patients to identify medication related problems and optimization opportunities Collect relevant information from various sources to understand the history and clinical status of the patient Complete patient centered assessment, considering functional status, risk factors, cultural factors, treatment goals, and health literacy Assess medicat

Screens and identifies members with high risk, long term chronic conditions who will benefit from care management services. Monitors utilization as needed. Referrals for cases may originate from various sources Performs member evaluations and onsite visits as needed in multiple settings, including but not limited to telephonic, member's homes, PCP/Specialists clinic, hosp

Demonstrates a high level of performance in the Patient Access Center employee role and effectively establish, prioritize, and balance the various duties of both the lead and employee roles Provide first level support to the Patient Access team A technical professional who assists with the development and tracking of department metrics and will provide reports and updates

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Provide telephonic outreach to engage members discharged to home/community following an inpatient admission Conduct telephonic clinical case management with engaged members for the 30 day transition of care period. Services include conducting post discharge assessments, medication review and reconciliation, identification of gaps and barriers in discharge plans and SDoH n

Assist in end to end provider claims and help enhance provider experience Assist in efforts to enhance ease of use of provider portal and future services enhancements Support development and management of provider networks within assigned regions Help implement training and development of external providers through education programs in collaboration with our training tea

Provides mental, behavioral, and/or psychological treatment services or therapy directly to patients utilizing a variety of treatment methodologies Services/treatment/therapy may be provided in individual or group environments and may be provided virtually or in person Assists patients and their families to change behaviors and to locate and access interpersonal, family a

Posts patient and insurance payments to the correct account within the prescribed timeframe with a 95% or higher accuracy rate. Analyzes and resolves accounts where underpayments, overpayments or non payments have occurred. Completes adjustments for denials or non covered services Research needed to recover remits not received Balances payments and direct deposits Maintai

Partner with business leadership to understand business operations and objectives, socialize Workplace Security Programs, and ensure business leaders are informed of Corporate Security resources, expertise, and guidance Provide business leadership with security incident reporting metrics and actionable data and develop an understanding of business leadership perspective r

Critical performance responsibilities Compiles and maintains accurate and timely information on contract performance for all fee for service and value based contracts in a database, including renewal dates, cancelation notices and provider relations contacts Assist in the development of a fee for service and value based contracting strategy for Medicare, Commercial and Me

Performs screening and diagnostic mammography examinations Assists in maintaining records and reports consistent with MQSA Enter data into computer and ensures accuracy Adheres to policies, procedures and regulations to ensure compliance and patient safety Maintains credentials and/or licensure Attends and participates in departmental meetings Performs other duties as ass

Works providing direct patient care. Obtains and evaluates patient medication regimens, allergies and past/current medical history. Designs, recommends and monitors patient specific therapeutic regimens with evidence based medicine. Uses collaborative drug therapy management protocols for disease state management. Examples include diabetes, hypertension, hyperlipidemia, a