- Molina Healthcare (Spokane, WA)
- The Clinical Services Auditor performs auditing of clinical staff in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health ... knowledge of NCQA standards for case management, and understanding of state Medicaid contracts. The Auditor should have the ability to reference/ remember rules,… more
- MyFlorida (Tallahassee, FL)
- …to the Agency for Persons with Disabilities (Agency) in the area of consumer services and supports and Medicaid -related litigation in various forums before the ... and levels of services and supports for the Home and Community-Based Services (HCBS) iBudget Waiver program, and related Medicaid determinations by the… more
- MyFlorida (West Palm Beach, FL)
- …Beginnings Centralized Intake and Referral Agencies based on client consent for services and risk screen results ensures Medicaid eligibility for reimbursement ... Agencies in accordance with the requirements of the Children's Services Council of Palm Beach County grant. Works as...supporting documentation with each submission that includes character of service (for example, DD Form 214 Member … more
- DESC (Seattle, WA)
- …able and willing. + Create and submit initial crisis plan for after-hours crisis services . **Case Management:** + Participate as a member of a multi-disciplinary ... and is represented by SEIU Healthcare 1199NW. **About DESC:** DESC (Downtown Emergency Service Center) is a nonprofit organization working to help people with the… more
- MyFlorida (Tallahassee, FL)
- …a variety of duties and is under the direct supervision of the Accounting Service Supervisor II. The duties and responsibilities of this Accountant IV position ... entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000...supporting documentation with each submission that includes character of service (for example, DD Form 214 Member … more
- MyFlorida (Lake City, FL)
- …referrals provided to other agencies in collaboration with Healthy Start. Help Clients obtain Medicaid services and services to OB care. Will attend ... cannot be completed by the RN. Help clients obtain Medicaid services as needed. Designs and develops...supporting documentation with each submission that includes character of service (for example, DD Form 214 Member … more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and ... Applies case management criteria and professional clinical judgment to determine a member 's appropriateness for case management services . + Initiates case… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Association, the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and coordination with the ... clinical reviews of medical records to ensure correct billing of services and appropriateness of care, interviewing potential witnesses, developing corrective action… more
- Sunrise Senior Living (Fort Belvoir, VA)
- …Profit and Loss (P&L) Summary reporting, balance sheet account reconciliations, Medicare/ Medicaid billing and adherence to Sunrise Senior Living business process ... Duties** As a part of the Sunrise team, supporting our Mission, Principles of Service and Core Values is a fundamental part of this job. Our foundational belief… more
- Fresenius Medical Center (Annapolis, MD)
- …"material assist" devices for the heavier items. **EDUCATION** + Center for Medicaid /Medicare Services (CMS)-approved state and/or national certification or High ... + Become a Member of the Annapolis Dialysis Team + Dialysis...SCOPE:** Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including… more
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