- NewYork-Presbyterian (Brooklyn, NY)
- …experience that a successful applicant will need are listed in the following description. Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days Located ... to the surrounding communities for over 135 years. The Case Manager is responsible for all aspects...inpatient criteria or continued inpatient stay - Coordinating expedited appeals for inpatient denials with attending physicians and insurance… more
- Ralliant (Albany, NY)
- **Job Title:** Product Manager **Location:** Remote, USA **Job Summary:** As a key contributor within Hengstler-Dynapar, the **Product Manager ** will guide the ... aligns with the company's business objectives while collaborating cross-functionally. The Product Manager will work closely with all functions within our company to… more
- Molina Healthcare (Houston, TX)
- …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... * Provides second level behavioral health clinical reviews, peer reviews and appeals . * Supports behavioral health committees for quality compliance. * Implements… more
- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and ... to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and...work. On the job or formal training in certified case management, denial and appeals management from… more
- Rush University Medical Center (Chicago, IL)
- …may vary depending on the circumstances of each case . **Summary:** The system manager of denials prevention and appeals , working in a remote environment will ... of Epic automation and ancillary coding software solutions. The manager will exemplify the Rush mission, vision and values...Middle Revenue Cycle Audit and denials team members and appeals process, ensuring timely and accurate submission of … more
- Elevance Health (Indianapolis, IN)
- ** Appeals Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... is granted as required by law. Alternate locations may be considered. The ** Appeals Medical Director** is responsible for the appeal reviews for physical health… more
- Elevance Health (Los Angeles, CA)
- **Behavioral Health Medical** **Director-Psychiatrist** ** Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of ... clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/ Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case management ... term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager ... Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) - American Case...Cycle/HIM regarding RAC decision to appeal, denials, input into appeals , share findings with providers.Review all cases with readmission… more
- Calvary Hospital (Bronx, NY)
- The RN Case Manager (RNCM) will be responsible for all aspects of case management for an assigned group of patients to determine the appropriateness of the ... Assessment and Performance Improvement activities of the Department of Case Management. Assesses, plans, coordinates, implements and evaluates patient's health… more
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