- AdventHealth (Tampa, FL)
- …you'll need to succeed:** Associate's of Nursing Required. 1 years Related Experience Required Registered Nurse ( RN ) current FL Required CCDS - Certified ... as needed, to enhance staff development; leads hiring, training and performance management processes for all site-based CDI employees; coaches, mentors and empowers… more
- Ascension Health (Austin, TX)
- …+ **Call Schedule:** 1 in 3 call + **Practice Detail:** Genetic counselor, registered nurse , social worker, administrative staff + **EMR System:** Athena + ... of 2 Genetic Counselors (GC) to 1 Attending Physician. Additionally, we have RN staffing, CMA (certified medical assistant) staffing, a Social Worker and a robust… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National certification ... functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, financial, and… more
- UNC Health Care (Rocky Mount, NC)
- …Facilitates effective and cost-efficient care of patients through such case management functions as utilization review and discharge planning. May facilitate the ... care, or may concentrate on one aspect of case management , depending on the area assigned. In collaboration with...patient reassessments according to identified needs and input from RN and MD. Serves as a resource person for… more
- Carle Health (Champaign, IL)
- …Administrator (RHIA) - American Health Information Management Association (AHIMA); Licensed Registered Professional Nurse ( RN ) - Illinois Department of ... nurses, ancillary staff, and the coders in Health Information Management to identify and record principal and secondary diagnoses,...peers and providers we needed or requested. Reviews DRG denials and provides information to the denials … more
- MVP Health Care (Rochester, NY)
- …you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after ... At least 3 years of recent clinical and Case Management experience. Experience working in a Medicaid Long Term...and manage Medical Loss Ratio (MLR). + Appeals & Denials : Participate in the appeals process for denied services… more
- Arnot Health (Elmira, NY)
- … registered nursing program with a current license as a registered nurse . BSN or Case Management Certification preferred. EXPERIENCE: Three to five years ... in quality improvement and evaluation processes related to the management of patient care . The Case Manager will...trends LOS , resource utilization , outliers, readmissions , denials , delay days and satisfaction of the case… more
- Henry Ford Health System (Detroit, MI)
- …for pre- and post-payment audit processes. This is more than managing denials -it's about driving payer behavior change, leveraging data to influence outcomes, and ... is responsible for overseeing pre- and post-payment audit processes, managing denials and appeals, and driving payer behavior change through data-driven insights… more
- Presbyterian Homes and Services (Roseville, MN)
- …sites by directing the other RAI Directors on the approved plan. Qualifications + Registered nurse with current licensure the State Board of Nursing in states ... UB04's for clinical billing), review ancillary service charges. + Determine denials /communications at IDT, track residents in 30 day window, monitoring regulatory… more
- Access Dubuque (Dubuque, IA)
- …company. The PFS Representatives appeal claims appropriately, work to find root cause of denials , and think outside of the box to find solutions to payment problems. ... be expanded to include other duties and responsibilities as management may deem necessary from time to time. 1....account for rules specific to each payer 5. Reviews denials , appealing when necessary and identifying and recommend solutions… more