Adoration Home Health and Hospice
Location
Memphis, Tennessee
The Utilization Review Nurse processes authorization requests and clinical inquiries according to plan benefits and established guidelines, collaborating with internal teams like inpatient review nurses and Medical Directors to ensure timely determinations for medical services. Responsibilities include performing reviews for various services, consulting with Medical Directors when criteria are not met, and communicating decisions to providers and members.
Candidates must possess a current, unrestricted Registered Nurse (RN) license with multistate capability. Preferred qualifications include at least one year of experience in Utilization Management/Review and managed care, along with knowledge of medical terminology and Medicare authorization processes.
As a Home Health Account Executive, You will: Increase market share by sustaining and growing key established accounts, and by identifying and developing new referral sources through prospecting, lead generation, and sales calls within an assigned territory Meet with and educate referral sources about the services of the agency by providing in-service Educate referral sources on appropriate documentation, including Face-to-Face, and the criteria patients must meet for admission to home care services Collaborate with agency leadership to establish an agreed-upon approach for engaging referral sources that ensures the insurance payer mix aligns with company expectations Execute weekly, monthly, and quarterly strategies to increase market share through key account development of existing and prospective accounts Provide professional guidance to referral sources and internal operational staff to ensure
Bachelor’s degree in business administration, Advertising, Marketing, Communications, or a related field or more than 2 years of sales experience Successful experience in business development or healthcare-related role About our Line of Business Adoration Home Health and Hospice, an affiliate of BrightSpring Health Services, provides quality and compassionate services in the comfort of home, providing support for patients, families, and caregivers in their time of need. Adoration was formed to fill the need for a loving, community-focused, caring organization. We empower patients to live with dignity, find a sense of fulfillment, and celebrate with their families a life well-lived. Our employees and caregivers are proud to be a part of the Adoration team and the mission of our company. For more information, please visit www.adorationhealth.com. Follow us on Facebook and LinkedIn.
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