- Henry Ford Health System (Troy, MI)
- The purpose of the Central Authorization Specialist position is to centrally facilitate the successful procuring of insurance authorizations for ordered procedures ... providing timely and accurate information to payors'. The Central Authorization Specialist helps drive change by identifying areas where performance improvement is… more
- Option Care Health (Panama City, FL)
- …patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the ... the best and brightest talent in healthcare. **Job Description Summary:** The Specialist , Patient Access - Specialty Operations is responsible for facilitating new… more
- CVS Health (Columbus, OH)
- …member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly ... goals and interventions to meet their identified needs. . Documentation : Maintain meticulous documentation of care management...the Care Manager RN within the Care Team for clinical knowledge, medication regimes, and supportive clinical … more
- Banner Health (Gilbert, AZ)
- …deliver unprecedented levels of cancer care in Arizona. As an Outpatient Oncology Clinical Pharmacist at Banner MD Anderson Medical Center, you will work alongside ... utilizes the electronic surveillance partnership in caring for the patient, where remote nurses have the ability to interact with patients via two-way audio-video… more
- Molina Healthcare (Rockford, IL)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes to one or ... Quality Interventions and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and… more
- Molina Healthcare (Detroit, MI)
- **Job Description** **Job Summary** The Specialist , Member & Community Interventions implements new and existing clinical quality member intervention initiatives ... of department interventions + Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables +… more
- Henry Ford Health System (Grand Blanc, MI)
- …Supervisor, in conjunction with OP Audit Analysts and Coordinators will utilize documentation and coding expertise to facilitate audits of the quality and ... completeness of medical record documentation for outpatient encounters, including but not limited to...medical record, the OP Audit - outpatient complex audit specialist will be responsible for utilizing knowledge of Local,… more
- Trinity Health (Livonia, MI)
- …Shift Position - Part-Time -32 Hours Per Week - Day Shift) Work Remote Position (Pay Rate: $24.5303-$36.7954) Responsible for the data capture, analysis & reporting ... are placed on the claim appropriately including ancillary or clinical systems related to revenue cycle, charge capture &...(5) or more years of experience in billing, charge documentation , charge audit or charge capture activities, or other… more
- Guidehouse (Minneapolis, MN)
- …Necessity edits + Other claim level edits as assigned + As needed, review clinical documentation and diagnostic results as appropriate to validate and apply ... None **Clearance Required** **:** None This position is fully remote **What You Will Do** **:** + Under the...medical necessity of services provided and charged based on provider/ clinical documentation . + Knowledge, understanding and proper… more
- Nuvance Health (Danbury, CT)
- …during the first level review, discuss with the attending MD to obtain additional clinical information and documentation to support inpatient level of care. If ... *Description* *FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIRED* * *Hybrid/ Remote * * *Summary:* The purpose of the Denial Prevention Nurse is to… more