- CenterWell (Orlando, FL)
- …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... for the development, implementation and management oversight of the company's Medicare /Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work… more
- Houston Methodist (Houston, TX)
- …with HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... At Houston Methodist, the Director Case Management & Social Services RN position is responsible for strategy, function and operations of the Case Management & Social… more
- CenterWell (Hampton, VA)
- …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in Virginia or Compact ... for the development, implementation and management oversight of the company's Medicare /Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case ... accuracy of information provided to providers, regulators, law enforcement, Legal, Compliance and outside counsel. Prepares cases for prosecution, civil settlement,… more
- Insight Global (San Francisco, CA)
- …review and sign off on care plans, maintain clinical quality standards, and ensure compliance with Medicare guidelines. You'll play a critical role in bridging ... the San Francisco area is looking to hire an RN Case Manager. In this role, you will supervise...patient care, clinical operations, and compliance , ensuring our patients receive consistent, proactive ,… more
- CenterWell (Tampa, FL)
- …part of our caring community and help us put health first** The RN Coding Education Facilitator is responsible for delivering clinically relevant coding education to ... providers, nurse practitioners (NPs), and physician assistants (PAs) in a...value-based care priorities like risk adjustment accuracy, quality performance, compliance , and effective patient management. **Key Responsibilities** + Deliver… more
- CVS Health (Trenton, NJ)
- …home). Standard working hours Monday - Friday 8-5 pm EST. **ICM Case Manager RN ** **WFH Flexible** **Position Summary:** Help us elevate our patient care to a whole ... life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range...member's overall wellness. The ICM care manager develops a proactive plan of care to address identified issues to… more
- CVS Health (Lansing, MI)
- …models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... medical needs of the member to facilitate the member's overall wellness. Develops a proactive plan of care to address identified issues to enhance the short and… more
- Tufts Medicine (Lowell, MA)
- …**Job Description** **Minimum Qualifications:** 1.Current licensure as a Registered Nurse or Physical Therapist. 2. Massachusetts RN Licensure OR Physical ... Life Support (BLS) Certification **Preferred Qualifications:** 1. Bachelor's prepared level preferred- Registered Nurse BSN preferred, or Physical Therapist with… more
- CenterWell (Orlando, FL)
- …our caring community and help us put health first** We're looking for a Registered Nurse ( RN ) who's passionate about education, clinical documentation, and ... Curriculums. In this role, you'll blend your clinical expertise-especially in Medicare Risk Adjustment (MRA) and HCC coding-with instructional design skills to… more