- Medical Mutual of Ohio (OH)
- … Medicare Supplement, and individual plans. Under limited supervision, the Medicare Nurse Reviewer applies medical necessity guidelines in making ... for applicants that have a strong clinical utilization management background. Medicare experience is a plus. **Responsibilities** + Evaluates clinical information… more
- Parkview North Hospital (Fort Wayne, IN)
- …eligible for a $5,000 sign-on bonus Summary Works independently to perform Medicare Annual Wellness Visits and facilitates advance care planning conversations using ... patients of PPG in accordance with the individual patient's needs, Medicare Wellness Clinic standing orders, physicians'/advanced practice providers' orders, PPG and… more
- Beth Israel Lahey Health (Boston, MA)
- …eligible to obtain provider numbers from insurance carriers that currently contract nurse practitioners ( Medicare , Medicaid, Blue Cross/Blue Shield etc.) Joslin ... **Please click on this link to apply to the Nurse Practitioner (Adult) position via HMFP. (https://hmfp.wd5.myworkdayjobs.com/HMFP/job/Joslin-Diabetes-Center/ Nurse -Practitioner--Adult-Diabetes\_R0964… more
- Cassia (Buffalo, MN)
- …therapy IDT. + Document patient progress during TCU stay. + Participating in the Medicare team meetings. Health Plan Nurse skills and requirements: + RN or ... Center is currently seeking an experienced Full-Time Health Plan Nurse to join our team! As a Health Plan...should have LTC experience along with e xperience with Medicare and patient's insurance. We will train the right… more
- Mary Greeley Medical Center (Ames, IA)
- …Performance Excellence Program (https://www.mgmc.org/about/quality-safety/expect-the-best/) , and the Centers for Medicare and Medicaid. As a nurse in Magnet ... & 457(b) Deferred Compensation + Generous PTO plan + Nurse Residency + Nursing Professional Development Opportunities + Tuition...any licensure, certification, education): + Licensed as a Registered Nurse and authorized by the State of Iowa to… more
- Mary Greeley Medical Center (Ames, IA)
- …Baldrige Performance Excellence Program (https://www.mgmc.org/about/quality-safety/expect-the-best/) , and the Centers for Medicare and Medicaid. As a nurse at a ... & 457(b) Deferred Compensation + Generous PTO plan + Nurse Residency (https://www.mgmc.org/careers/ nurse -residency-program/) + Nursing Professional Development… more
- AdventHealth (Orange City, FL)
- …physician and in compliance with regulations and standards identified by the Medicare Hospice** Conditions **of Participation, Florida Nurse Practice Act, and ... 1055 Saxon Blvd Orange City, FL **The role you'll contribute:** **The Registered Nurse Inpatient unit provides skilled professional nursing care and support to the… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …Organ Procurement and Transportation Network (OPTN) policies and Centers for Medicare /Medicaid Services (CMS) regulations The Nurse Practitioner supports the ... JOB SUMMARY: The Nurse Practitioner, Solid Organ Transplant Coord provides comprehensive...nurses and others on the health care team. The Nurse Practitioner, Solid Organ Transplant Coord responsibilities include all… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Under general ... external guidelines.** **Prepares and assigns cases/files to clinical staff ( Nurse , Social Worker, Care Navigator, Physician)** **.** **Responsibilities** + **Sends… more
- Baptist Memorial (Memphis, TN)
- Summary Medicare / Medicaid Appeals Registered Nurse reviews and evaluates medical documentation to support billing compliance and external regulatory ... PREFERRED 5 years of healthcare care experience and 3 years in Medicare billing environment. Previous audit experience, knowledge of InterQual and Medicare… more
- Molina Healthcare (Long Beach, CA)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review, and manages the denial… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... required + A Certified Risk Adjustment Coder (CRC), required + Registered Nurse (RN) or clinical qualifications a plus + Bachelor's degree (healthcare or… more
- Queen's Health System (Honolulu, HI)
- …* In addition to the educational requirement, three (3) years experience as a Medicare Certified Home Health Nurse , preferably in a comparable institution. * One ... * Under the general direction of the Director of Medicare Certified Services, the Nursing Clinical Manager has oversight...Science. * Current Hawaii State license as a Registered Nurse . * Valid US driver's license, vehicle and vehicle… more
- The Cigna Group (Bloomfield, CT)
- This position, the Nurse Case Manager Senior Analyst, through the case management process, will promote the improvement of health outcomes to members and assist ... situations, clients and customers. **Minimum requirements:** + Active and unrestricted Registered Nurse (RN) license in state or territory of the United States +… more
- Molina Healthcare (TX)
- …Certification, Association** Active and unrestricted Licensed Clinical Social Worker Registered Nurse , Compact nursing licensure _WORK HOURS 5 days / daytime work ... schedule, some weekends and holidays. *PREFERRED , Tues thru Saturday or Sunday thru Thursday._ To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a… more
- Elderwood (Waverly, NY)
- Salary $36.00 - $52.00 Overview Are you a Registered Nurse (RN) with Medicare experience? Do you consider yourself an expert in assessment and reimbursement ... the facility based MDS/PPS departments. + Completes and/or oversees completion of all Medicare PPS MDS and/or OBRA assessments for both subacute and long-term care.… more
- New York State Civil Service (Binghamton, NY)
- NY HELP Yes Agency Mental Health, Office of Title Licensed Practical Nurse (NY HELPS), Greater Binghamton Health Center, P25464 Occupational Category Health Care, ... - Statewide (NY HELPS) program as a Licensed Practical Nurse if they have:* License and current registration to...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- Fairview Health Services (Edina, MN)
- …in a variety of care settings throughout the 11-county metro area. The FVP Nurse (RN) Care Coordinator provides coordination across all settings of care and performs ... Minnesota Department of Health (MDH) and the Centers for Medicare and Medicaid Services (CMS). **Job Expectations:** Assessment +...during HRA, as appropriate; if a licensed public health nurse , may perform assessment independent of HRA + Performs… more
- New York State Civil Service (Brooklyn, NY)
- NY HELP Yes Agency Mental Health, Office of Title Registered Nurse Supervisor 1 Psychiatric, (NY HELPS), Kingsboro Psychiatric Center, P25877 Occupational Category ... 11203 Minimum Qualifications Kingsboro Psychiatric Center is recruiting a Registered Nurse Supervisor 1 Psychiatric to supervise registered nurses and direct care.… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Licensed Practical Nurse (NY HELPS), Manhattan Psychiatric Center, P25846 Occupational Category Health Care, ... - Statewide (NY HELPS) program as a Licensed Practical Nurse if they have:* License and current registration to...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more