- St Croix Hospice (Eau Claire, WI)
- …Communication + Communicates and collaborates with the interdisciplinary group to create, review and revise the patient's plan of care. + Consults with the ... Additional Duties + Maintains knowledge of and compliance with current Medicare /Medicaid, state/federal rules and regulations for hospice services + Ensures… more
- Molina Healthcare (Janesville, WI)
- …products to coordinate a medical plan of care and capture diagnoses for Medicare risk adjustment. The NP/PA will utilize advanced assessment skills to diagnose and ... present at the time of the visit. Obtain vital signs, measure BMI, review pharmacological therapy and conduct a physical examination. + Capture and document annual… more
- Banner Health (WI)
- …knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment ... accurate coding based on documentation for positive outcomes. 5. Performs ongoing audits/ review of inpatient and/or outpatient medical records to assure the use of… more
- Centene Corporation (Madison, WI)
- …healthcare coverage, providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals and families served by the ... cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality assurance, and… more
- Marshfield Clinic (Eau Claire, WI)
- …are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum ... are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum… more
- Marshfield Clinic (Horicon, WI)
- …the department 4. Assists in policy and procedure development and review 5. May participate in interviews **JOB QUALIFICATIONS** **EDUCATION/EXPERIENCE** **Minimum ... are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum… more
- Molina Healthcare (Milwaukee, WI)
- …care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU ... also entails producing audit reports for internal and external review . The position may also work with other internal...+ Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace. + Understanding of… more
- Marshfield Clinic (Minocqua, WI)
- …are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum ... are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum… more
- Marshfield Clinic (Marshfield, WI)
- …a resource to the care team with regards to discharge planning, and provides review of medical utilization to third party payers to obtain certification for the ... experience in a medical facility. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a clinic/hospital setting.… more
- Marshfield Clinic (Eau Claire, WI)
- …are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum ... are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum… more