Insurance - Waltham, MA, US
LifePlans Inc. has been helping long-term care and health insurers, plans and providers manage risk through innovative, evidence-based solutions since 1987. Our industry leading services drive demonstrated improvements in health outcomes and business performance. For 25 years we have been developing, managing and deploying a National Clinical Network of over 4,000 nurses for clinical interventions:Underwriting and benefit eligibility determinations:•Care coordination •Fall prevention •Care transitions programs to reduce hospital readmissions We deploy our telephonic assessment and call center capabilities to: •Underwrite and determine claim eligibility with telephonic assessments •Conduct health risk assessments in accordance with Centers for Medicare and Medicaid requirements •Welcome and enroll members, verify services, and provide new initiative member outreach calls •Coordinate and manage ongoing care •Conduct market surveys Our sophisticated analytic capabilities include•Risk Classification algorithms and analytic reporting •Research with government and industry to affect health policy •Development of research design to estimate ROI impact of clinical interventions LifePlans is dedicated to providing the highest quality data and solutions to our clients. We clinically review 100% of our in-person assessments, evaluate and train clinical staff and employ an internal QA team dedicated to identifying and analyzing performance trends and issues.EQUAL OPPORTUNITY EMPLOYER: LifePlans is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, gender, religion, national origin, disability, veteran status, age, marital status, sexual orientation, gender identity, genetic information, or any other class protected by federal or state law (EEO/AA).
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