- US Tech Solutions (AZ)
- …**Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. ... responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for… more
- US Tech Solutions (May, OK)
- **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You ... responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for… more
- General Dynamics Information Technology (Sacramento, CA)
- …None **Job Family:** Project/Task Management **Skills:** Business Analysis,Mainframe Software, Medicare ,Project Management **Experience:** 10 + years of related ... configure, and maintain mainframe operating systems and associated software. + ** Medicare Systems Knowledge:** In-depth understanding of Medicare programs,… more
- New York State Civil Service (Thiells, NY)
- …and procedures when needed to ensure the provision of quality care. * Review of lab work, specialty consults, hospital discharges, medical visit summaries and ... the group home, the hospital, the rehabilitation setting and/or community providers.* Review and approval of discharge summaries prior to accepting an individual… more
- MetroLink (Los Angeles, CA)
- …will be forwarded to the hiring authority for consideration. The first review of applications begins April 14, 2025. Interested applicants are encouraged to ... budget, and assist accounting department with timely billing on projects. + Review submittals from contractors and consultants for conformance with the requirements… more
- MetroLink (Los Angeles, CA)
- …series. WHAT TO EXPECT: This recruitment is open competitive and will have a review of applications on June 15, 2025. Interested applicants are encouraged to apply ... as heavy trucks, construction, etc.). Selection Process: Following a review of applications and resumes, the most highly qualified...exceeds $50,000, be added to your Federal, State, and Medicare taxable earnings for W-2 reporting. This amount is… more
- New York State Civil Service (Schenectady, NY)
- …clients in that location. Duties would include, but not be limited to review and establish medical histories, perform physical examinations, and manage the medical ... nutrition services to develop individualized therapy plans as necessary.* Review discharge plans from hospitalizations to resume care in...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- UCLA Health (Los Angeles, CA)
- …UCLA Health. In this highly analytical role, you will lead the preparation and review of financial and statistical information for Medicare and Medi-Cal cost ... reimbursement, and support audit processes. You will: + Prepare, review , and analyze financial and statistical data for ...review , and analyze financial and statistical data for Medicare and Medi-Cal cost reports. + Serve as the… more
- Diversicare Healthcare Services & Diversicare Ther (Haysville, KS)
- …a skilled care documentation specialist, ensuring accurate and timely completion of Medicare and Managed Care regulatory guidelines. + Review Additional ... Documentation Requests (ADRs) to ensure all documents meet the request. **Qualifications** 1. Degree in nursing, therapy or other related clinical field (ie social services), must hold a current license in respective field. 2. Knowledge of healthcare… more
- Catholic Health Initiatives (Houston, TX)
- …Skills, Abilities and Training: * Comprehensive knowledge of utilization management, Medicare , Medicaid, and commercial admission and review requirements. * ... In-depth knowledge of utilization management processes and best practices. * Strong managerial and decision-making skills. * Excellent communication skills and the ability to work collaboratively. * Proficient in healthcare IT systems relevant to utilization… more
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