- Option Care Health (Farmington Hills, MI)
- …Care and externally with customers (ex. medical director, head of case management, executive c-suite individuals). **Travel Requirements** **: (if** **required)** + ... Basic understanding of billing and reimbursement procedures for hospital, medical offices, and Medicare (B/D + benefits) as well as medical offices. + One year… more
- CVS Health (Lansing, MI)
- …best course of action to take in a timely and effective manner. Conducts case reviews and provides feedback to investigators on completeness and quality of the ... in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and written communication… more
- Trinity Health (Livonia, MI)
- …modifiers. Utilizes coding guidelines established by: + The Centers for Medicare /Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and Reporting, ... and office staff regarding documentation issues or needs. Communicates with case management concerning Outpatient Observation documentation issues. Works with HIM… more
- Centene Corporation (Lansing, MI)
- …of experience in Managed Care (UM, BH, CM) preferred. Familiarity with Medicare and Medicaid programs preferred. **Licenses and Certifications:** A license in one ... Health Counselor (LMHC), or Licensed Marital and Family Therapist (LMFT). Certified Case Manager (CCM) preferred.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
- Molina Healthcare (Detroit, MI)
- …contact information is current and up to date. + Effectively communicate general Medicare and Medicaid plan benefits to existing members. + Interact with appropriate ... with completion of comprehensive medication reviews through pre-work up to case preparation. + Proactively identify ways to improve member relations. **Job… more
- Trinity Health (Farmington Hills, MI)
- …office staff, Patient Access, Medical Records/Health Information Management, Utilization Review/ Case Management, Managed Care, Ancillary and Nursing staff, as ... insurance and governmental programs, regulations and billing processes (eg, Medicare , Medicaid, Social Security Disability, Champus, Supplemental Security Income… more
- Trinity Health (Muskegon, MI)
- …meet those needs in the home care setting. + If therapy only case , informs the client/caregiver about the agency, care/services available, client obligation for ... nursing, therapy (physical, occupational, speech) and medical social work. We are Medicare -certified and accredited by The Joint Commission. Learn more about us at… more
- Corewell Health (Watervliet, MI)
- …aspects of IRF-PAI tool including transmission of records to the Centers for Medicare and Medicaid Services (CMS) and other insurances as needed. Monitor and educate ... sub acute rehabilitation Required + Familiarity with different diagnostic groups for Case Mix Group (CMG) selection and IRF-PAI tool. Preferred + Experience with… more
- ChenMed (Detroit, MI)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... PCP will engage with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be… more
- Trinity Health (Ann Arbor, MI)
- …healthcare financing and managed care. Knowledge of and experience in case management and utilization management. Outpatient CDI experience preferred. Knowledge of ... insurance and governmental programs, regulations, and billing processes (eg, Medicare , Medicaid, Social Security Disability, Champus, Supplemental Security Income… more