- Humana (Springfield, IL)
- …with other managers (especially the Quality Manager, Utilization Manager, and Medical Director ) and departments to address and resolve member grievances and appeals. ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Trinity Health (Des Moines, IA)
- …of the Clinical Integration Specialist is to assist and support the Director in quality and safety strategies, plans, and regulatory requirements that improve ... strategies, regulatory and accrediting body requirements (ie, Centers for Medicare and Medicaid Services (CMS), Iowa Department of Inspections and… more
- Atlantic Health System (Morristown, NJ)
- …safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in ... all team members. Offerings vary based on role level (Team Member, Director , Executive). Below is a general summary, with role-specific enhancements highlighted:… more
- Dialysis Clinic, Inc. (Albuquerque, NM)
- …appointments, and ensures the patients' charts are in order in accordance with Medicare and company policies and procedures. **Schedule** : Three 8-hour days, shifts ... on absences. Provides reports to the nurse manager or area operations director . + May perform duties of receptionist including sorting and distributing mail,… more
- Saint Francis Health System (OK)
- …requests, obtain appropriate authorizations for all plans (managed care, Medicaid, Medicare ) and coordinate the scheduling of the "referred to" specialty including ... other healthcare professionals and staff. Works frequently with individuals at Director level or above. Special Job Dimensions: None. Supplemental Information: This… more
- Sharp HealthCare (San Diego, CA)
- …EMR.Assure correct documentation is present for 2MN benchmark and presumption.Assure Medicare Inpatient to observation status changes follow Condition Code 44 ... and refers cases for consultation with Physician Advisor or Medical Director as appropriate.Oversee preparation, delivery and documentation of non-coverage letters.… more
- Humana (Springfield, IL)
- …and Resolution Professional reports to the Claims Research and Resolution Associate Director and is responsible for tracking and trending IL FIDE D-SNP claims ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Atlantic Health System (Morristown, NJ)
- …safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in ... all team members. Offerings vary based on role level (Team Member, Director , Executive). Below is a general summary, with role-specific enhancements highlighted:… more
- BAYADA Home Health Care (Wilmington, MA)
- …fill the position of **Home Health Nurse Manager** for our **Wilmington, MA** Medicare Certified home health office. This office provides best-in-class care to adult ... provide exceptional care. + Work closely with the Rehab Manager (where applicable), Director , and DCO to ensure cohesive and consistent management of all field… more
- Atlantic Health System (Morristown, NJ)
- …safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in ... all team members. Offerings vary based on role level (Team Member, Director , Executive). Below is a general summary, with role-specific enhancements highlighted:… more