Amerigroup Wa Work Values

Daily Duties at Amerigroup Wa:

 Evaluated the appropriateness and efficiency of services provided by performing utilization management and quality management activities through thorough, and timely retrospective record reviews as required or assigned.  Utilized the InterQual Clinical Guidelines to support better patient outcomes.  Performed in-depth analysis, clinical review, and resolution of provider appeals/inquires and subscriber reconsiderations.  Investigated and reviewed member and provider appeals and ensured they were resolved in a timely manner to meet regulatory timeframes.  Documented and logged appeal information on relevant tracking systems and mainframe systems.  Conducted HEDIS 2014 medical record reviews by auditing work submitted by a vendor for accuracy, doing file over-reads, and preparing files for submission to regulators.

What they like about Amerigroup Wa:

You give high priority to hiring firms with prestige. Market reputation and prestige of a firm may be determined through on-line research, and conversations with individuals working in your target industry. Note that firms "in the public eye" receive a great deal more critical publicity and attention than those operating with more anonymity. So as you assess your employment opportunities, be sure to seek out the positive aspects of the firm's reputation in addition to noting negative publicity the company may have received.

Tags

Seattle, Nursng, Utilization Review, Clinical Appeals, Medicare & Medicaid, Education, Case Management, Regstered Nurse

Skills

appeals review, chart review, documentation evaluation, use of clinical guidelines, professional relationships, evaluation of care provision, patient assessment, compliance with standards and procedures, use of multiple EMR systems, teaching, clinical supervison, use of Microsoft Office

These are some of the questions we asked our climbers about their experiences with Amerigroup Wa: