- Sedgwick (Dallas, TX)
- …+ Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents ... coding is correct. + Refers cases as appropriate to supervisor and management . + Delegates work and mentors others. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** +… more
- Molina Healthcare (TX)
- …oversight team, supports the implementation of newly identified delegates for care management . * Serves as subject matter expert for local health plan state ... to vendors as needed. * Assists in preparation of documents for utilization management , care management , state, CMS, NCQA and other regulatory audits as… more
- Sharecare (Austin, TX)
- …to Clinical Advocates ( Nurse ) for conditions that require clinical care and case management assistance + Primary duties include but are not limited to: ... new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and… more
- Sedgwick (Austin, TX)
- …for evaluating the following: + Conducting reviews on cases where the nurse is seeking treatment plan clarification, claim denial, disability certification or ... duration management for return to work guidance. + Generating phone...+ Provides MRO expertise in special cases where a case is escalated. + Provides assistance where occupational health… more
- Ascension Health (Austin, TX)
- …education regarding the clinical documentation process. + Conduct hiring, training, management , development and evaluating of staff. + Collaborate with members of ... data to support strategic development and improvement activities related to case mix index, MS DRG and value-based purchasing reimbursement, and quality/outcomes… more
- ZOLL Medical Corporation (San Antonio, TX)
- …include: Physicians (Cardiologists, Electrophysiologists, Hospitalists, CT Surgeons etc.), Nurse Practitioners, Physician Assistants, nurses, case managers ... patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …experience, preferably in a behavioral healthcare setting, phone triage, tele-health or case management or combination of education and experience. Experience in ... enforces the level system or other methods of behavior management . + Maintain patient, program, department, and related documentation....out general nursing assistance as assigned and supervised by nurse in charge. + Maintains a safe, orderly, and… more
- BrightSpring Health Services (Corpus Christi, TX)
- …services/training programs on a routine basis in cooperation with Operations management ; monitoring both skilled and non-skilled healthcare services + Directly ... and Medicare standards, as well as state reimbursement regulations + Leading case conferences and other client-related meetings + Chairing committees as appropriate,… more
- Medtronic (Abilene, TX)
- …(based off quarterly Plan of Action as directed by Leadership) + Assists Management and Sales Training department in education/training of new employees in the ... purchase orders and product replacement + Expected to work with materials management to collect POs for cases covered within the territory/district + Responsible… more
- BrightSpring Health Services (Harlingen, TX)
- …services/training programs on a routine basis in cooperation with Operations management ; monitoring both skilled and non-skilled healthcare services + Directly ... and Medicare standards, as well as state reimbursement regulations + Leading case conferences and other client-related meetings + Chairing committees as appropriate,… more