- County of Northampton (Nazareth, PA)
- …employment opportunities (EEO) to all persons regardless of race, color, national origin, religion, sexual orientation, marital status, sex, gender identity, gender ... and provides clinic nursing care, and assists with providing nursing and medical support services to residents and employees at Gracedale Nursing Home. The… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and… more
- Mount Sinai Health System (New York, NY)
- …workflows and quality reporting measures. This position will report to the Director of the Enterprise CDM. **Qualifications** + Bachelor's degree in public ... working with the Professional Charge Description Master, preferably in an academic medical center. + 5 plus years with Epic Experience, Epic certification desirable.… more
- University of Colorado (Aurora, CO)
- **Peer Recovery Specialist Patient Services** **Description** **University of Colorado Anschutz Medical Campus** **School of Medicine | Department of Psychiatry | ... of health such as issues of housing, transportation, Medicaid and/or Medicare enrollment, food/nutrition, access to health care, provide referrals to necessary,… more
- CenterWell (Anderson, SC)
- …active participant and leads the care team through daily huddles. + Helps Associate Medical Director (AMD), Physician and Center Administrator in setting a tone ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...be screened for TB. **Preferred Qualifications** + Experience managing Medicare Advantage panels of patients with understanding of best… more
- AdventHealth (Orlando, FL)
- …under the general supervision of the Care Managment Supervisor or Manager or Director of Nursing and is responsible for patient evaluations of post-hospital needs; ... Care coordination, discharge planning, transitions of care planning and understanding of medical necessity are core competencies of this role. The RN Care Manager… more
- AdventHealth (Hinsdale, IL)
- …and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care coordination. The Social ... not limited to the following: Home Health, Infusion Services, Durable Medical Equipment, Palliative Care, Hospice, Outpatient Services, Transitions of Care Clinics,… more
- Dartmouth Health (Hampstead, NH)
- …psycho education and recreation groups under supervision of clinician or program director . * Provide opportunities for residents to attend and participate in ... in hospital safety training programs and meets with the Program Director for ongoing mentoring, guidance, and supervision. * Utilizes interventions consistent… more
- Lincoln County (Newport, OR)
- …ongoing management of the client. + Consult and coordinate with physicians, Health Center Medical Director , Associate Medical Director , and Primary Care ... request from Program Manager, Deputy Directors or Health Center Medical Director to evaluate level of care...Oregon at the time of appointment. Possession of a National Certificate for Medicare , or the ability… more
- Cognizant (Annapolis, MD)
- …. Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a... Medicare , Medicaid, and third-party guidelines. . Effectively document and… more
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