- UPMC (Pittsburgh, PA)
- …and present in-service training on accurate DRG assignment for coding personnel, the medical staff, physician extenders (PAs, CRNPs), nursing case management and ... DRG reimbursement issues among coding, nursing administration, Patient Business Services, medical staff, case management, and other ancillary departments… more
- Humana (Harrisburg, PA)
- …and experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received by members ... a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- UPMC (Pittsburgh, PA)
- …DRG reimbursement issues among coding, nursing administration, Patient Business Services, medical staff, case management, and other ancillary departments ... and present in-service training on accurate DRG assignment for coding personnel, the medical staff, physician extenders (PAs, CRNPs), nursing case management and… more
- Help at Home (Philadelphia, PA)
- …strongly preferred. + Familiarity with referral networks tied to VA hospitals, medical centers, case managers, or veteran-serving clinics/social services is ... you'll serve as a community ambassador and advocate-building relationships with VA medical centers, clinics, social workers, and referral partners to ensure Veterans… more
- Robert Half Legal (Philadelphia, PA)
- …surrounding counties to ensure timely submissions and compliance. * Gather and organize medical records essential for case preparation and review. * Prepare ... with experience in personal injury cases and a strong understanding of case management systems will thrive in this position. Responsibilities: * Manage e-filing… more
- Select Medical (York, PA)
- **Overview** **Critical Illness Recovery Hospital** ** Case Manager** **$5000 Sign On Bonus** _Requires a current licensure in a clinical discipline either as a Nurse ... (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work (license per state guidelines)._ _And_ _Previous...and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource… more
- Datavant (Pittsburgh, PA)
- …level of professionalism required at all time + Ability to roll and lift a 45lb equipment case for medical chart retrievals or maneuver a 25lb soft case + ... will arrive at scheduled times and scan/upload the assigned medical records using Datavant equipment and processes. + Datavant...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- AmeriHealth Caritas (Philadelphia, PA)
- … policies and procedures adhere to contractual obligations. + Performs clinical case reviews in conjunction with Medical Excellence Department. + Demonstrates ... Thoroughly documents all care coordination activity in the member medical record in the electronic case management...the member medical record in the electronic case management documentation system.; + Adheres to AmeriHealth Family… more
- Highmark Health (Pittsburgh, PA)
- …medical provider.Assist patients to set health goals by working cooperatively with medical providers, case management departments and/or health plans to help ... job will be responsible for helping patients to navigate and access medical care, community services/resources and develop healthy behaviors. The Senior CHW will… more
- Highmark Health (Erie, PA)
- …medical provider.Assist patients to set health goals by working cooperatively with medical providers, case management departments and/or health plans to help ... job will be responsible for helping patients to navigate and access medical care, community services/resources and develop healthy behaviors. The incumbent will act… more