- Banner Health (AZ)
- …number of accounts for specific patient types and specialties in combination with the Case Mix Index and case financial information to formulate performance to ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
- Tucson Electric Power (Tucson, AZ)
- …quality of life in the communities we have served for generations, and in TEP's case , since the 1890s. We're building a cleaner, greener grid, with more wind and ... bodies and assists in the execution thereof (eg, ACA reporting, Medicare Notice of Creditable Coverage, PCORI fees, conducting monthly pension reconciliation… more
- Molina Healthcare (Scottsdale, AZ)
- …the pharmacy benefit changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary care team. + Works ... the pharmacy call center team as delegated by the Manager . + Identifies and implements programs to improve clinical...License for workplace and plan location. **Preferred Experience** + Medicare Part D or Medicaid experience. + Managed care… more
- Cardinal Health (Phoenix, AZ)
- …helps manufacturers rethink how far their products can go. **Accountabilities** The Case Manager supports patient access to therapy through Reimbursement Support ... prior authorizations, and appeals, preferred (2+ years) + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies, preferred… more
- Banner Health (Chandler, AZ)
- …and challenges), an in office team of QI specialists, telehealth resources, clinical manager and in office triage support. This structure is designed to assist field ... "alone" in the field! We recognize that our nurse case managers are the key to a successful journey...than the national and Arizona average in almost all Medicare Quality Compare patient satisfaction results. POSITION SUMMARY This… more
- Molina Healthcare (Tucson, AZ)
- …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
- Fresenius Medical Center (Kingman, AZ)
- …with another staff member presentPosition functions as an onsite Patient Educator and Case Manager for patients with various shifts and work hours **EOE, ... diploma or GED required. + Must meet Centers for Medicaid and Medicare Services (CMS)-approved state and/or national certification requirements within the required… more
- Highmark Health (Phoenix, AZ)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs...related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges… more
- Gentiva (Yuma, AZ)
- …applicable regulatory agencies - ie, keeping personnel records up-to-date for Medicare surveys. + Maintains updated copies of all applicable regulations, statutes, ... + Coordinates with the appropriate corporate staff, Medical Director, Clinical Manager , and Executive Director or Administrator all activity necessary to assure… more
- Banner Health (Gilbert, AZ)
- …and challenges), an in-office team of QI specialists, telehealth resources, clinical manager and in office triage support. This structure is designed to assist ... "alone" in the field! We recognize that our nurse case managers are the key to a successful journey...than the national and Arizona average in almost all Medicare Quality Compare patient satisfaction results. POSITION SUMMARY This… more
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