- Lowe's (Charlotte, NC)
- **Your Impact** The Care Manager is a telephonic medical case management position with emphasis on early intervention, return to work planning, coordination of ... treatment to an appropriate resolution. Apply medical treatment guidelines for future Medicare -covered expenses. The candidate will work directly for a Fortune 100… more
- Molina Healthcare (Bronx, NY)
- …of long-term services to chronically ill or disabled people who are eligible for Medicaid and Medicare . We are looking for Case Managers with a New York LMSW or ... and Supports (LTSS) is highly preferred. Strong organizational and time management skills. The Case Manager must have the ability and be comfortable to working in a… more
- Genesis Healthcare (Lebanon, NH)
- …MDS Nurse -- RN manages the overall process and tracking of all Medicare /Medicaid case -mix documents to ensure appropriate reimbursement for all services ... Medicare /Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable. *Must maintain current BLS/CPR… more
- Henry Ford Health System (West Bloomfield, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. ... CONTINGENT DAYS POSITION GENERAL SUMMARY: The Case Manager is a member of the hospital...and family's health care needs. The goals of the case manager are to promote patient safety, quality of… more
- Henry Ford Health System (Troy, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. + ... now hiring passionate & dedicated RN or Social Worker Case Managers to join a new Henry Ford Health...with some remote work day options. GENERAL SUMMARY: The Case Manager is an interdependent member of the patient-centered… more
- Henry Ford Health System (Clinton Township, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. . ... Under the direction of VP Operations, CNO, the Regional Director of Case Management is responsible for the development, implementation, and/or monitoring of the… more
- Skyline Nursing Center (Dallas, TX)
- …government agencies. * Assigns, assists, and instructs staff in the RAI Process, PPS Medicare , Medicaid ( Case Mix as required) and clinical computer system in ... in a Skilled Nursing Facility preferred. * Excellent knowledge of Case -Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required. * Thorough… more
- US Tech Solutions (RI)
- …volume where needed. **Responsibilities:** + Utilizing multiple software systems to complete Medicare appeals case reviews + Meeting or exceeding government ... clients or lines of business and in accordance with Medicare Part D CMS Regulations. + Must apply information...improvement and customer service **Skills:** + Prior Authorization + Medicare and Medicaid + Call handling experience. **Education:** +… more
- US Tech Solutions (May, OK)
- …volume where needed. **Responsibilities:** Utilizing multiple software systems to complete Medicare appeals case reviews Meeting or exceeding government mandated ... requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. Must apply information provided through multiple channels… more
- US Tech Solutions (May, OK)
- …volume where needed. **Responsibilities:** + Utilizing multiple software systems to complete Medicare appeals case reviews + Meeting or exceeding government ... requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. Must apply information provided through multiple channels… more
- Molina Healthcare (Nampa, ID)
- …should have proficient knowledge of MS Suite, organized and analytical thinking . Medicare knowledge/experience is highly preferred. The Case Manager must be ... service. This position will be supporting our Washington State Medicare plan. We are seeking a candidate with previous... plan. We are seeking a candidate with previous Case Management experience and a WA LCSW or LCISW… more
- SouthPointe Healthcare Center (Indianapolis, IN)
- …timely completion of mds assessments and coordination of the RAI process. Provides Medicare , Medicaid ( case mix), and managed care oversight to ensure ... term care environment preferred + Experience with the MDS/RAI process and/or case management preferred JOB RESPONSIBILITIES The MDS Nurse RAC (Resident Assessment… more
- UPMC (Washington, PA)
- …care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization/ case management, discharge planning, Medicare , Medicaid, and ... **Purpose:** The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable for the… more
- Cambridge Health Alliance (Cambridge, MA)
- …effective and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case Manager will collaborate with ... RN Case Manager - Inpatient Case Management CH **Date Posted:** 11/06/2024 **Requisition Number:** 8614 **Location:** CHA Cambridge Hospital **Work Days:**… more
- Cambridge Health Alliance (Everett, MA)
- …effective and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case Manager will collaborate with ... RN Case Manager - Inpatient Case Management Everett **Date Posted:** 01/07/2025 **Requisition Number:** 9129 **Location:** CHA Everett Hospital **Work Days:**… more
- Priority Health Care (Marrero, LA)
- …+ Ensures submission of required paperwork in a timely manner (log sheets, case openings/closings, Medicaid/ Medicare forms, etc ) + Adheres to office protocol. ... SUMMARY: Reporting to the Social Services Lead the Intensive Housing Case Manager provides case management services to chronic homeless people in the community,… more
- Medical Mutual of Ohio (OH)
- …remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** **Responsibilities** ** Medicare ... supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part C (medical drug)… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s ... our members achieve their best possible health and quality of life. ** Medicare Sales Operations Specialist** Executes all end-to-end functions relating to the… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #266 Monday, December 2, 2024 Centers Plan for Healthy Living's goal is to create the ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and...external processes are followed + Update customer file in Case Tracker with summary of interaction + Interact with… more
- Genesis Healthcare (Pennsburg, PA)
- …standards of care. *Manage the overall process and tracking of all Medicare /Medicaid case -mix documents to assure appropriate reimbursement for services provided ... within the nursing center. *Conduct concurrent MDS reviews to assure achievement of maximum allowable RUG categories. *Integrate information from nursing, dietary, social services, restorative, rehabilitation, and physician services to ensure appropriate… more