- Datavant (Phoenix, AZ)
- …work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide guidance and make strategic ... + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Banner Health (Phoenix, AZ)
- **Primary City/State:** Phoenix, Arizona **Department Name:** Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care Find your path in health care. ... clinical expertise truly matter. As a Master Social Worker Case Manager on our Care Coordination team, you'll be...across the continuum of care. 4. Maintains knowledge of Medicare , Medicaid and other program benefits to assist patients… more
- CenterWell (Phoenix, AZ)
- …the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including ... the decision to admit patients to service. Assigns appropriate clinicians to a case , as needed. + Instructs and guides clinicians to promote more effective… more
- Molina Healthcare (AZ)
- …RN Licensure._ _Case Manager RN will work in remote setting supporting our Medicare /Medicaid population who have recently been admitted into Hospital. The Case ... position and productivity is important. Preferred candidates will have previous case management, managed care, hospital, and/or home health experience._ _This role… more
- Banner Health (Tucson, AZ)
- **Primary City/State:** Tucson, Arizona **Department Name:** Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care The future is full of possibilities. ... and addressing any barriers to effective patient care. Our Case Managers support various hospital units and typically rotate...across the continuum of care. 4. Maintains knowledge of Medicare , Medicaid and other program benefits to assist patients… more
- Banner Health (Mesa, AZ)
- **Primary City/State:** Mesa, Arizona **Department Name:** Case Mgmt-Hosp **Work Shift:** **Job Category:** Clinical Care Great careers are built at Banner Health. ... you. As the Transitional Care Associate, you will assist Case Managers on the Care Coordination Team with the...date and potential care settings. 7. Maintains knowledge of Medicare , Medicaid and other program benefits to assist patients… more
- Humana (Phoenix, AZ)
- …start time is 10:00AM EST.** Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. We ... to day flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare , Medicaid, and/or and Group Account members and create actionable and… more
- HonorHealth (AZ)
- …Responsible for coordinating and conducting medical necessity reviews for all Medicare , AHCCCS, Self-pay, and all other payers, upon admission and concurrently ... (such as timeliness and appropriateness of services). Collaborates with physicians, case managers, payers and others to appeal individual denials and trended… more
- Datavant (Phoenix, AZ)
- …+ Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, ... requirements will be reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in which you will be working, exemptions… more
- Banner Health (AZ)
- …knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment ... National Correct Coding Initiative (NCCI) and the effect on Case Mix Index by use of specialized software. 7....contacts. Must consistently demonstrate the ability to understand the Medicare Prospective Payment System, and the clinical coding data… more