- Tufts Medicine (Boston, MA)
- …data and generate reports. Reports malfunction to help desk. 10. Collaborates with case management staff, social workers and nursing staff to facilitate follow ... role that focuses on support of daily business activities (eg, technical, clinical , non- clinical ) operating in a "hands on" environment. The majority of time is… more
- CVS Health (Harrisburg, PA)
- …accuracy and appropriateness of a benefit/administrative denial. * Can review a clinical determination and understand rationale for decision. * Able to research ... 1-2 years Medicare part C Appeals experience. - Project management skills are preferred. - Strong knowledge of all... skills are preferred. - Strong knowledge of all case types including all specialty case types… more
- Virtua Health (Voorhees, NJ)
- …the unit/department.Communicates and collaborates extensively with other caregivers, physicians, case management , patient and/or patient's families or ... unit/department as well as those of individual patients.* Interacts with physicians and case management to coordinate care and effectively problem solves to… more
- Virtua Health (Mount Holly, NJ)
- …unit/department. Communicates and collaborates extensively with other caregivers, physicians, case management , patient and/or patient's families or significant ... as well as those of individual patients. + Interacts with physicians and case management to coordinate care and effectively problem solves to establish… more
- Corewell Health (Farmington Hills, MI)
- …a case load of patients that includes facilitating utilization management , and/or care coordination during the patient's stay, planning and expediting plans ... the care for groups of patients as it relates to disease management , resource utilization, access, discharge planning, quality, service and efficiently across the… more
- Catholic Health Initiatives (Omaha, NE)
- …two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. RN license ... representative and post acute care providers in accordance with the patients clinical or psychosocial needs, choices and available resources. Oversees and evaluates… more
- Trinity Health (Pittsburgh, PA)
- …stage of change. + Provide engagement opportunities, assist consumers with meeting all case management needs, and provide both individual and group therapy. ... in Psychology, Social Work, or Human Services and 1 year of clinical experience, preferably diagnosing and treating psychiatric conditions. + Certified Alcohol and… more
- Catholic Health Initiatives (Bryan, TX)
- …hospital clinical experience with ADN or a Master's degree in Case Management , or Master's Degree Nursing TX RN License **Licensure/Certifications:** ... representative and post-acute care providers in accordance with the patient's clinical or psychosocial needs, choices and available resources. 3. Oversees and… more
- Catholic Health Initiatives (Omaha, NE)
- …two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. RN license ... representative and post acute care providers in accordance with the patients clinical or psychosocial needs, choices and available resources. Oversees and evaluates… more
- US Tech Solutions (RI)
- …+ Maintains complete, timely and accurate documentation of reviews. + Transfers all clinical questions, escalations and judgement calls to the pharmacist team. + The ... Rep I, Clinical Services will also assist with other duties as...issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. + Must maintain compliance at… more