- Penn Medicine (Philadelphia, PA)
- …scheduling appointments as needed. Ensures testing is scheduled in accordance with CMS guidelines for organ acquisition. Assists patients with completing the HLA ... UNOS waitlist. Mails and tracks missing patient consent forms, CMS 2728 forms, etc + Timely completion of updates...to patients approved to continue with evaluation. + Waitlist Management Support + Assists in the performance of waitlist… more
- AmeriHealth Caritas (Philadelphia, PA)
- …as assigned. + Document all activities, correspondence, and outcomes in the case management system with attention to detail and accuracy. **_Compliance & ... it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other… more
- Sunnyside Nursing and Post-Acute Care (Torrance, CA)
- …+ The Health Information Manager (HIM) is responsible for the overall management of the Medical Records Department, including the development and implementation of ... of ethical coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. When applicable, serves as… more
- Texas Health Resources (Fort Worth, TX)
- …and evaluates complaints and grievances to determine appropriate response based on CMS guidelines and hospital policy. * Prioritize concerns in multiple or complex ... within regulatory federal and state agencies. * Maintains compliance with the CMS Centers for Medicare and Medicaid Services Conditions of Participation, other… more
- Actalent (Sacramento, CA)
- …case management , or hospital discharge planning + Familiarity with CMS inpatient criteria, including the Two-Midnight Rule + Proficiency in Microsoft Office ... for Medicare inpatient admissions, continued stays, and discharges + Apply CMS regulations and evidence-based criteria (MCG, InterQual) to evaluate medical necessity… more
- Idaho Division of Human Resources (Coeur D'Alene, ID)
- …and use; + Appearing in court as needed; + Entering and reviewing data in the Case Management System ( CMS ) according to CMS guidelines; + Tracking own ... time in the CMS ; + Maintaining confidentiality of client information and adhering to ethical standards; + Attend case planning and strategy meetings; + Working with clients from diverse cultural, racial, and socio-ethnic backgrounds; + Working both in an… more
- State of Colorado (CO)
- …INTEGRATION BUSINESS ANALYST: + Department's Staff Authority for Colorado Medicaid Enterprise System (CMES) system and interface design, data integration, API ... CMES integration and eligibility systems, MITA 3.0 standards, and federal CMS guidance to design and validate technical solutions that operationalize policy… more
- Hartford HealthCare (Manchester, CT)
- …accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing unnecessary ... for preoperative, concurrent, and retrospective reviews in accordance with the utilization management plan. The UM CM ensures the appropriate status and level of… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …focused on ACA, Medicaid, and/or Medicare Advantage is essential. Knowledge of CMS ACA EDGE, Medicare Advantage response files (MAOs), and/or Minnesota Medicaid ... highly valued. Proficiency with healthcare file formats, understanding of CMS guidelines, and excellent problem-solving abilities are important. Strong communication… more
- MyFlorida (Tallahassee, FL)
- …coordinating the ongoing development and support activities of the Health Clinic Management System , Immunization registry, and children's medical services data ... - 64001456 Date: Dec 22, 2025 The State Personnel System is an E-Verify employer. For more information click...works with central office, county public health department and CMS clinic management staff. + This position… more