- UPMC (Washington, PA)
- …with management of departmental budget. + Collaborates with Director, Medical Director/ Physician Advisor and staff to ensure effective processes and systems ... Case Management functions: training, auditing, systems support: Case Management Technology, InterQual, Concurrent Denials and reporting. Leads efforts… more
- Carle Health (Urbana, IL)
- Overview The Health Information Management Coding Manager provides day-to-day oversight, direction and management for the hospital inpatient and hospital ... accuracy and timeliness of all the coding completed within Health Information Management . The position is responsible for planning, analyzing and development of… more
- Nuvance Health (Rhinebeck, NY)
- …medical information from insurers and other sources to the case managers and physician advisor . * Obtains Medicaid & Managed Medicaid Authorization for patient ... *Description* Summary: Coordinates inpatient denials for the hospital with emphasis on data...denials for the hospital with emphasis on data management and reporting. Coordinates and manages all Utilization Review… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …be responsible for: + Prioritize and manage communications relating to insurance requests, denials and Physician Advisor status recommendations to the ... post-acute care referrals, to assist with length of stay management and mitigation of denials . + Communicate...length of stay management and mitigation of denials . + Communicate and collaborate with interdisciplinary team, patients,… more
- Sharp HealthCare (San Diego, CA)
- … management venues.Escalate and refers cases for consultation with Physician Advisor or Medical Director as appropriate.Oversee preparation, delivery ... a comprehensive plan of care for each patient/family in collaboration with the physician , social worker and all members of the interdisciplinary team in the… more
- Highmark Health (Pittsburgh, PA)
- …for denial trends with the care coordination teams, performance improvement teams, physicians/ physician advisor and third party payers. + Maintains a working ... coordination of care in accordance with recognized standards of practice for Care Management . Professional role model utilizing expertise in care management to… more
- Eastern Connecticut Health Network (Manchester, CT)
- …and takes appropriate action when variances are identified. + Works with the Physician Advisor to ensure appropriateness of care, cost-effectiveness and best ... at the other hospital as needed. Reports to the Manager of Care Management . EDUCATION/CERTIFICATION + Graduate of an accredited school of Nursing + Baccalaureate… more
- St. Luke's University Health Network (Allentown, PA)
- …assignment of documented medical care for appropriate reimbursement. + Work with the physician advisor in review of patient medical records identified by ... of diagnosis and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed… more
- Alameda Health System (San Leandro, CA)
- …when cases do not meet criteria - coordinates denials with the attending physician , and the UR physician advisor . Prepares case reports; documents ... Social Services + Part Time - Day + Care Management + $58.74 - $97.91 per hour + Req...of Medi-Cal, self-pay, and out-of-plan patients, including working with physician to determine readiness for transfer, securing placement and… more
- Houston Methodist (The Woodlands, TX)
- …case manager to facilitate discharge planning, seeks assistance from the physician advisor , if needed, and informs management of the possible need for ... is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted patient population on a designated unit(s) and/or service… more