- Highmark Health (Dover, DE)
- …Work **LICENSES OR CERTIFICATIONS** **Required** + Required (any of the following): + Registered Nurse + Licensed Social Worker (LSW) - Non-Specific + Licensed ... enhanced Nurse Licensure Compact (eNLC). **Preferred** + ACM Certification (Accredited Case Manager ) **SKILLS** + Adult Learning: Theory and Practice +… more
- Hackensack Meridian Health (Edison, NJ)
- …systems; Google Docs, EPIC. **Licenses and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support HCP ... of Health + Good working knowledge of benefit plans; Medicaid -HMOs, etc. + Computer skills to include Google Docs...Certification. **Licenses and Certifications Preferred** : + Certified Case Manager or Accredited Case … more
- Chenega Corporation (Maxwell AFB, AL)
- …or Family Nurse Practitioner (FNP). + Possess and maintain a current and unrestricted Registered Nurse ( RN ) license. + Possess and maintain a current and ... Nurse Practitioner** (NP) will be the Primary Care Manager (PCM) for a panel of up to 1,300...and manage specific pediatric illnesses. + Prepare and review case histories and clinical records of newborns, infants, children,… more
- Covenant Health Inc. (Crossville, TN)
- …of Joint Commission Standards and Medicare Conditions of Participation. Licensure Requirement: Registered Nurse licensed in the state of Tennessee. Employee must ... Overview Senior Risk Manager and Regulatory Specialist, Quality Managment Full Time,...and other inquiries from outside sources. + Maintains risk case files and strives to maintain maximum protection from… more
- Beth Israel Lahey Health (Plymouth, MA)
- …League for Nursing accredited school of nursing. Licensure, Certification & Registration: * Registered Nurse licensed in the state of MA Experience: * 3-4 ... referral appropriateness * Demonstrates a solid understanding of the Medicare, Medicaid , and Private insurance environment and promotes coordination with the… more
- Trinity Health (Albany, NY)
- …degree is strongly preferred). Master's degree preferred. Certification (CPHRM) is preferred. Registered Nurse preferred. Ideally, the candidate will have 3-5 ... visitors, vendors, various regulatory and professional agencies. **SUPERVISED BY:** Manager of Risk Management **SUPERVISES:** none **CAREER PATH:** Management… more
- Elevance Health (Wilmington, NC)
- …through Foster Care and Adoptive Assistance programs is strongly preferred. + Certified Case Manager Certification is highly preferred. + Experience serving the ... _We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid -enrolled infants, children, youth, young… more
- Fallon Health (Milford, MA)
- … Managers to coordinate after care needs + The Navigator refers to the Nurse Case Manager /PCP whenever clinical decision making is required. ... the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the...and other data which may indicate a need for Nurse Case Manager involvement and… more
- UNC Health Care (Chapel Hill, NC)
- …the health and well-being of the unique communities we serve. Summary: The RN Quality Assurance Specialist will oversee the clinical documentation of the direct care ... clinical staff to ensure it is compliant with Medicare, Medicaid /state/federal regulations, and agency policies and guidelines; works closely with Performance… more
- HCA Healthcare (Charleston, SC)
- …guidelines in all interactions with the patient + In conjunction with the Medicaid Eligibility Staff visit all uninsured patients in-house + Provide estimates to ... insurance verification and precertification reports daily and follow up with case management and insurance verification departments as appropriate + Follows all… more
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