- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the daily ... operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical review and authorization creation for… more
- Sutter Health (Sacramento, CA)
- …& LICENSURE:** CPC-Certified Professional Coder OR CCSP-Certified Coding Specialist -Professional OR CCS-Certified Coding Specialist **TYPICAL EXPERIENCE:** ... and requirements, knowledge of Quality Coding requirements such as the Medicare Advantage Coding Program/Hierarchical Condition Category + (HCC), as well as… more
- Geisinger (Scranton, PA)
- …and efficiency in the delivery of healthcare for the Medicaid, Medicare and Commercial populations. + Completes structured clinical assessments for identified ... closely with assigned primary care provider site and functions as a case manager for patients with behavioral health co-morbidities across the care team to develop… more
- Molina Healthcare (Augusta, GA)
- …(LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical ... online portals and databases. **Preferred Qualifications** + Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified… more
- Beth Israel Lahey Health (Burlington, MA)
- …a difference in people's lives.** Under general direction, the Research Program Manager will be responsible for managing, promoting, cultivating and overseeing all ... department.** **Acquires detailed knowledge of studies so to serve as a specialist ; Grasps the scope and objectives of projects.** **Triages calls from physicians,… more
- Magellan Health Services (Albuquerque, NM)
- …engagement experience with 1 year working with government-sponsored population, particularly Medicare and Medicaid. Self-starter with the ability to work with ... General Job Information Title CISC Member, Caregiver and Stakeholder Engagement Manager Grade 23 Work Experience - Required Community Relations/Outreach Work… more
- University of Rochester (Albany, NY)
- …but not limited to, The Joint Commission TJC, Center for Medicaid and Medicare Services (CMS), National Committee for Quality Assurance (NCQA), State Department of ... quality of care. In collaboration with the Payer Enrollment Manager , coordinates the functions related to Delegated Credentialing/Commercial Payer Enrollment… more
- Bassett Healthcare (Oneonta, NY)
- …to department staff, serving as a resource and mentor. The Respiratory Care Specialist assists the Respiratory Supervisor, Manager , and Director with elements of ... of life possible. What you'll do Under general supervision by the Supervisor, Manager , and Director of Respiratory Care Services and working closely with the Medical… more
- New York State Civil Service (Staten Island, NY)
- …Chief Physical Therapist, Chief Recreation Therapist, Developmental Disabilities Program Specialist 1, Developmental Disabilities Program Specialist 1 (Spanish ... Language), Developmental Disabilities Program Specialist 2, Developmental Specialist 4, Head Occupational Therapist, Head Physical Therapist, Head Recreation… more
- ChenMed (Largo, FL)
- …expanding and we need great people to join our team. The Manager , Referrals is a customer-service and leadership-focused position working directly with patients ... Checklist. + Communicates alternative/approvals to Referral Coordinator. + Follows up with MMD/ Specialist /MND if no response after 24hours. + Calls and follows up… more