- 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. ... (24 HOUR), MIDNIGHTS 7:00PM TO 7:30AM GENERAL SUMMARY: The Case Manager is a member of the hospital or...and family's health care needs. The goals of the case manager are to promote patient safety, quality of… more
- Henry Ford Health System (Detroit, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. + ... The Case Manager Social Worker provides therapeutic intervention and...and departmental policies and procedures. GENERAL SUMMARY: + The Case Manager is a member of the hospital or… more
- Henry Ford Health System (Jackson, 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 (Detroit, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. ... interviewing, etc. Applicant should also have a basic understanding of case management/care coordination and community resources. Applicant will be working with… more
- Humana (Lansing, MI)
- …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... includes some experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing Board Certification in an… more
- AmeriHealth Caritas (Detroit, MI)
- …about us at www.amerihealthcaritas.com. **Role Overview:;** Reporting to the Supervisor of Medicare LTSS Operations, the Medicare LTSS Care Coordinator manages ... needs. This role ensures that care is delivered by Centers for Medicare & Medicaid Services (CMS), state, and organizational guidelines, within the scope… more
- Molina Healthcare (Warren, MI)
- …and due-date logic * Proven history of building-or running-real-time dashboards that keep case aging within SLA * Demonstrated skill in root-cause triage that routes ... Quality, and Operations to fund high-return enhancements. **Core** ** ** **Duties** 1. Case Audits - Run scheduled and ad-hoc audits across internal and delegated… more
- Molina Healthcare (Detroit, MI)
- …the performance of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that ... License without restrictions (free of sanctions from Medicaid or Medicare ) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare… more
- CVS Health (Lansing, MI)
- …various life and work situations. + Appropriately documents member interactions and research/ case fulfillment in the system. + Works in an inbound and outbound ... + 1+ year(s) experience in social work, social services, or case management field. + Private, confidential workspace free from distractions.professional,… more
- CVS Health (Lansing, MI)
- …Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a business ... and clinical liaison to network providers and facilities if needed, to support the effective execution of medical services programs by the clinical teams. **Required Qualifications** *Two (2) or more years of experience in Health Care Delivery System eg,… more