- State of Colorado (Pueblo, CO)
- …for a position on a specific unit as indicated in this announcement and if the hiring manager chooses to extend a job offer to you, the hiring manager may make ... Accreditation Standards, Environment of Care Manual, Centers for Medicare and Medicaid Services, Safety Data Sheets, Colorado State Personnel Procedure Manual,… more
- Humana (San Juan, PR)
- …Rico. You must live in Puerto Rico for this position. The RN Care Manager works in a telephonic environment. They assess and evaluate members' needs and requirements ... and maintain an optimal wellness state. Using clinical knowledge, the Care Manager guides members with chronic conditions toward and facilitates interaction with… more
- Rochester Regional Health (Rochester, NY)
- …potential inpatient medical necessity denials. Review patient class in the event manager , assist with LOC determination retrospectively, and changes patient class as ... solving. REQUIRED QUALIFICATIONS: + 3 years of acute hospital care, Case Management and/or Utilization Management experience + Excellent oral and written… more
- Prime Healthcare (Chula Vista, CA)
- …with case management referrals and authorizations. Maintains and coordinates Medicaid state submission forms for presentation to on-site reviewer and files them ... coordination of the various activities of the CSU under the direction of the CSU Manager to assist with development and implementations of discharge plans. Assists… more
- Mental Health Association of SCK (Wichita, KS)
- …crisis intervention including documenting and incidents reporting to the resident's Housing Case Manager (HCM) and supervisor per department, agency policy and ... and cleanliness. The Residential Care Team Leader will provide AC/PR/TCM Medicaid billable services. Completion of state required, annual internal, and program… more
- Amergis (Fort Worth, TX)
- …Texas Education Agency and federal regulations. Case Management + Serve as case manager for students assigned for evaluations. + Maintain documentation for ... Medicaid billing and input evaluations, session notes, and progress reports into the district system. + Keep a database of referrals and evaluations for assigned… more
- State of Colorado (Denver, CO)
- …and applying statutes, regulations, guidelines, policies and procedures on a case -by- case , item-by-item basis for agency compliance/violation. + Works for ... occurrences and incidents of serious deficiencies and assesses whether Medicaid certified providers and licensed health facilities staff intervened appropriately.… more
- Molina Healthcare (Houston, TX)
- …License must be active and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification ... will be given to applicants with a minimum of 2 years' experience in Case Management/Service Coordination within an MCO. Candidates should be able to speak to how… more
- Molina Healthcare (AZ)
- …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... leadership and quality improvement teams. * Facilitates conformance to Medicare, Medicaid , NCQA and other regulatory requirements. * Reviews quality referred issues,… more
- HCA Healthcare (Fort Walton Beach, FL)
- …patients with discharge planning or psychosocial needs. + Obtains input from the RN case manager to ensure the discharge plan is appropriate and aligns with ... a thorough working knowledge of the rules of Medicare, Medicaid , and private payer regulations and processes, and possesses...do in this role: + Works collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and… more