- WelbeHealth (Pasadena, CA)
- …role in achieving our mission by performing skilled duties at home under CMS approval, bringing convenient and necessary care to our participants' homes. Under the ... after site licensure or in the event of pandemic/stay at home order with CMS approval to provide necessary care in the home. **Essential Job Responsibilities:** +… more
- Rochester Regional Health (Rochester, NY)
- …Days SUMMARY: Review all inpatient medical necessity denials for the health system based on InterQual and/or CMS guidelines. Responsibilities include managing ... Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week:...review the denials that do not meet InterQual and/or CMS guidelines for his/her recommendation regarding appeal options. +… more
- Golden Route Operations (Laughlin, NV)
- …number of new player sign ups each month. + Knowledge working with LMS and CMS when evaluating guests play and able to make sound comping decisions. + Knowledge on ... access and input information using a moderately complex computer system . + Knowledge on how to book a reservation...regulations + Perform any other duties as assigned by management . + Provide outstanding guest service to all internal… more
- State of Michigan (MI)
- …Medical Director for Michigan Veteran Homes (Grand Rapids or Chesterfield), both CMS -certified 128-bed long-term care facilities. Direct operations of the Home for ... Please select your level of experience in following Centers for Medicaid and Medicare Services ( CMS ) for long-term care. + None + Less than 1 year of experience +… more
- CTG (New York, NY)
- …and payment processing standards. + Work across multiple platforms, including CMS , eCommerce, CRM systems, cloud infrastructure, and CDN environments. + Collaborate ... Experience with databases and data integration. + Familiarity with cloud platforms, CMS , eCommerce, CRM systems, and CDN technologies. + Strong understanding of web… more
- Banner Health (AZ)
- …by offering remote and hybrid work settings. The Registered Nurse RN Medical Management Services is required to be technologically savvy when it comes to research ... help manage. Sites to aid in that research include CMS , Noridian, Optum360 Encoder Pro, (a provider lookup tool...contracted and noncontracted status,) and more. The RN Medical Management Services review Medicare Managed Care plans and receive… more
- Boehringer Ingelheim (Ridgefield, CT)
- …revenue management systems (eg, Model N), overseeing user training, system updates, and UAT requirements.Continuous Improvement & Special Projects: Identify and ... Value & Access, Commercial FP&A, and GTN to ensure data integrity, system accuracy, and alignment on pricing strategies. Provide government pricing impact… more
- ASM Research, An Accenture Federal Services Company (Arlington, VA)
- …meet call center target metrics + Ensures complete and accurate documentation in case management system ( CMS ) + Assists direct reports to deescalate callers, ... Cyber Awareness and PII to ensure access to the CMS system is maintained **Minimum Qualifications** +...to type 50 wpm + Excellent organization and time management skills + Comply with all HIPAA regulations +… more
- Avera (Tyler, MN)
- …data and information in the manner and at the time intervals specified by CMS and the State agency pertaining to participant care activities and outcomes. + Reviews, ... Long Term Care Director of Nursing with the day-to-day management and longer term planning of the patient care...regulations, and standards associated with, but not limited to, CMS , The Joint Commission, DHHS, and OSHA if applicable.… more
- Mount Sinai Health System (New York, NY)
- …+ In-depth knowledge of the coding process, coding systems software, workflow management , and excellent navigation of electronic medical records + Experience and ... working knowledge of various Health Insurance including CMS guidelines + Advanced knowledge of the ICD-10 CM/PCS...and billing rules + Previous experience with EPIC EMR system + Strong clinical and analytical skills to evaluate… more