- ChenMed (Memphis, TN)
- …years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population + Board eligibility is required. + Board Certified ... DUTIES/RESPONSIBILITIES:** + Directs accountability for clinical outcomes and day-to-day management of Medical Directors in multiple centers within assigned market,… more
- CVS Health (Austin, TX)
- …and delivery-planning, delivering, and supporting **Preferred Qualifications** + 5+ years Medicaid or Medicare experience (preferred) + People management ... assimilating information and data integration to develop quality improvement and management activities aligned with company strategies. + Candidate builds strong… more
- Houston Methodist (Sugar Land, TX)
- …is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted patient population on a designated unit(s) and/or service ... education to physicians, nurses, and other healthcare providers on case management topics. + Initiates contributions towards improvement of department scores for… more
- Houston Methodist (Nassau Bay, TX)
- …position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This position ... other staff and students. Serves a resource for case management and social work resources and needs for the...multiple tasks and role components + Knowledge of Medicare, Medicaid and Managed Care requirements + Comprehensive knowledge of… more
- CVS Health (Belleville, NJ)
- …members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , clinical coverage ... members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , clinical coverage… more
- Walgreens (Memphis, TN)
- …proper service to patients. Responsible for building relationships, overseeing the clinical management of patients, and growing the business at the site. Performs ... responding to special needs and proactively offering services. + Patient/Clinical Management + Collaborates with providers to determine appropriateness of therapy.… more
- Banner Health (Peoria, AZ)
- …correct payer(s) to each account and meet accuracy goals as determined by management . Collect payments and regular collection targets as determined by management ... financial counseling when appropriate. Meets productivity targets as determined by management . Demonstrates the ability to resolve customer issues and provide… more
- Veterans Affairs, Veterans Health Administration (Tacoma, WA)
- Summary This position is in the Health Information Management (HIM) section at the VA Puget Sound HCS. The Medical Records Technician (Coder) is skilled in ... codes for diagnoses, CPT/HCPCS codes for surgeries, procedures, and evaluation and management services. Review and abstract clinical data from the record for… more
- CVS Health (Woonsocket, RI)
- …And we do it all with heart, each and every day. **The** **PA Data Management (PDM)** **team oversees a wide range of Prior Authorization (PA) data flows, tools, and ... that drives meaningful impact across the healthcare ecosystem through robust data management practices. **Position Summary** As a **PA Data Management Analyst**… more
- Houston Methodist (Nassau Bay, TX)
- …and local coverage determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the plan of care and ... case manager, denials, and pre-bill team members, as well as management . **PEOPLE ESSENTIAL FUNCTIONS** + Establishes and maintains effective professional working… more