- SUNY Upstate Medical University (Syracuse, NY)
- …Syracuse Inc. (UUMAS) is seeking a Registered Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits ... and collaborate closely with Primary Care clinic Medical Directors and Nurse Leadership. Duties/Responsibilities: Identify Medicare patients overdue for their… more
- AmeriHealth Caritas (Detroit, MI)
- …psychosocial needs. This role ensures that care is delivered by Centers for Medicare & Medicaid Services ( CMS ), state, and organizational guidelines, within the ... it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... for providers and medical groups. + Participate in additional audit activities for CMS RADV as needed, including retrospective chart reviews. + Travel to provider… more
- BrightSpring Health Services (Knoxville, TN)
- …approved sales and marketing presentations in accordance with applicable Centers for Medicare & Medicaid Services ( CMS ) and State guidelines and standards. ... facility rollout meetings as needed. + Must communicate effectively with Medicare beneficiaries, their families, caretakers, nursing facility management and… more
- State of Colorado (Denver, CO)
- …with standards from regulatory bodies such as The Joint Commission (TJC), Centers for Medicare & Medicaid Services ( CMS ), and the Association for the Advancement ... Central Medical Supply Supervisor - NURSE III - G Wing Fort Logan Print...and SPD, including staffing, scheduling, equipment use, and space management . + Directly supervises CMS /SPD staff members;… more
- Veterans Affairs, Veterans Health Administration (Martinsburg, WV)
- …Assessments (CAAs) that are assigned to nursing, adhering to current Centers for Medicare and Medicaid Services ( CMS ) and Veterans Health Administration (VHA) ... and takes corrective action when notified by the CLC management team, charge nurse , or designee of...to the Austin Information Technology Center. Communicating Centers of Medicare and Medicaid Services ( CMS ) guidelines changes,… more
- Humana (Lansing, MI)
- …of our caring community and help us put health first** The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and independent ... appropriate treatment, care, or services for Enrollees. The Utilization Management Nurse Lead coordinates and communicates with...teams to ensure utilization reviews comply with Centers for Medicare & Medicaid Services ( CMS ) regulations as… more
- Bon Secours Mercy Health (Lorain, OH)
- …referrals to establish eligibility for care; understand and communicates Center for Medicare & Medicaid Services ( CMS ) medical necessity and admission criteria. ... excellence. **Primary Function/General Purpose of Position** The Admissions Coordinator Registered Nurse (RN) is responsible for the coordination of all Acute… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Team Lead plays a key role in supporting the day-to-day operations of the UM team and serves as a liaison between frontline ... regulatory compliance. Salary: $67,000/annually JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse Team Lead's responsibilities include but are not limited… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... care indicators and criteria as approved by medical staff, payer guidelines, CMS , and other state agencies. This position prospectively or concurrently determines… more
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